Florida health notes (1967)

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FLORIDA

HEALTH
NOTES

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t

The State Board of Health needs
additional resources to keep ahead
of the state's expanding population
and industrial growth which threat-
ens Florida's natural beauty. (Cover
photograph) Whether or not Billy
catches a fish depends upon the
amount of pollution dumped into
these waters by cities and industry.

1

\

~Jke

FIGHT

for

CLEAN
WATER

FLORIDA HEALTH NOTES

Publiihed monthly by the Florida State Board of Health, Wilton T. Sawder, M.O., M.P.H.,
State Health Officer. Publication office. Box 210, Jacksonville, Florida 32201. Second clan
Postage paid at Jacksonville, Florida. This publication is for individuals and institutions with
an interest in the state's health programs. Permission is givay to quote any story providing
credit is given to the Florida State Board of Health. Editor: Robert A. Sehoonover, M.A.,
Division of Health Educatton.

VOLUME 59 — NO. I

JANUARY 1967

FLORIDA HEALTH NOTES

TABLE OF CONTENTS

Page

Introduction 6

What are Water's Uses? 7

Overlapping Interests and Demands 7

What is Water Pollution? 8

What Causes Water Pollution ? , 11

Authorization of the State Board of Health

and County Health Departments 13

The Water Picture in Florida — 15

The State Board of Health's Concern about

Water Quality and Pollution - 17

J DOMESTIC SEWAGE 17

Florida's Expansion in Past 20 Years - 17

Domestic Effluent Discharges 22

Sewage Treatment is Necessary - 22

INDUSTRIAL WASTE _.„ 25

A More Vexing Problem 25

Industrial Pollution and Trouble Spots ~ ~. 27

Pollution from Agriculture 29

State Institutions and Pollution 32

ACnvnTES OF THE STATE BOARD OF HEALTH

AND COUNTY HEALTH DEPARTMENTS 34

Northeast Florida Region 35

Central Florida Region 37

Southwest Florida Region 38

Southeast Florida Region .„ 39

Dade County - 39

Broward County - 40

Manatee County 41

Hillsborough County 41

Pinellas County - _ 42

Palm Beach County _ 43

Water Pollution Is a Health Problem „,. .-.. 43

4 • FLORIDA HEALTH NOTES

THE STATE BOARD OF HEALTH'S

RESOURCE PROBLEMS 45

Personnel and Finances 45

The Lack of Engineers ~- 46

Budget Requests — . 46

Legal Aspects of Water Pollution — 48

Legal Action by the State Board of Health 49

Are We Willing to Pay for What We Want? - 50

SELECTED BIBLIOGRAPHY 52

APPENDIX A— Letters between Ray L. Wilson, attorney,

and Wilson T. Sowder, M.D., Florida State Health Officer 55

APPENDIX B— Report from Vincent D. Patton, director of

Division of Industrial Waste 61

APPENDIX C — Reports from regional sanitary engineers 66

1. Nick Mastro, Northeast Florida Region 66

2. G. W. Folke, Central Florida Region 68

S. E. M. Larsen, Southwest Florida Region 72

4. Richard Starr, Southeast Florida Region 78

5. K. K. Huffstutler, Polk-Hillsborough

Air Pollution Control District 80

APPENDIX D — Reports from county sanitary engineers 83

1. Robert L. Quick, Dade County 84

2. George T. Lohmeyer, Broward County 86

3a. Frank L. Cross, Manatee County 88

Supplemental reports from Manatee County... 90

3b. Allen Kretschmar, sanitarian 90

3c. George Dame, M.D., director 92

4. Donald W. Rogers, Hillsborough County 94

6. Harold Leadbetter, Pinellas County 96

6. Lawrence D. Lukin, Palm Beach County 101

APPENDIX E— "Health Aspects of Water Pollution"

from weekly compilation of Presidential Documents 103

APPENDIX F— Letters from Wilson T. Sowder, M.D.,

Florida State Health Officer, and Howard W. Chapman,

associate regional health director for environmental

health, U. S. Public Health Service, Region IV 109

FLORIDA HEALTH NOTES • 5

The Fight For Clean Water

Water is necessary for all
living things. All of the
larger, and many of the smal-
ler species of life — animal,
plant and man — are de-
pendent upon this mixture of
hydrogen, oxygen and some
33 other separate substances
for their very existence.

Water is the most massive
quantity of liquid material
on earth. There are some 336
million cubic miles of it in
one form or another. About
98 per cent of this water is
in the oceans and seas and
most of the rest is locked up
in ice on polar caps and
glaciers. Man gets along on
a small .027 per cent in fresh-
water rivers, lakes and ground
water. These vital stocks of
water are replenished by an
even tinier but highly mobile
.000053 per cent which moves
around in the atmosphere and
falls as rain. 1

From earliest times, man
has settled where water and
food were plentiful. He learn-
ed that plants and animals
needed water. The first civili-
zations grew in the river val-
leys of the Nile, Tigris, Eu-

phrates, Indus and Ganges
and whole tribes moved up
and down the rivers looking
for new lands and a better
life. For centuries there has
been enough water to dilute
the wastes that man has
dumped into the waters of the
earth. There was a time when
waters were polluted only by
the falling leaves of the trees
and the soil that it picked up
in its movement. In a con-
tinuing cycle, trees, plants and
grasses protected the water
and soil with their roots.

But with expanding popu-
lations and evolving civiliza-
tions, man developed many
uses for water besides the
necessary activities of drink-
ing, cooking, bathing and
transportation. He removed
the trees and plants which
held the soil; he poured raw
sewage into the streams ; and
with industrialization, he add-
ed much more dangerous
pollutants.

In 1900, a person used an
average of five gallons of
water per day for his own
use. Today, the United States
has become a nation of con-
centrated communities. Even

1. Rum, Ch»rl« E. Thm John* Hopkint Magatms. Vol. IT, No. 8. July !M6, p. S.

6 • FLORIDA HEALTH NOTES

though Florida's cities are bright and sparkling as compared with
the grime of Northern communities, the daily bath is a social
"must" ; clothes, household linens and curtains need frequent wash-
ing ; and there is an ever-increasing growth of lawn sprinklers, air
conditioners, electric dishwashers and backyard swimming pools.

The average Floridian uses 50 gallons of water a day for his
own personal use. If domestic and municipal uses are included,
the amount averages 150 gallons a day; with the inclusion of
agricultural and industrial products, it averages from 1500 to
2000 gallons per person each day.

What are Water's Uses

There are many groups interested in water. Each has its own
use of the resources. Everyone wants clean water for human con-
sumption — that is for drinking, cooking and bathing.

Clean water is needed for producing food, watering stock, irri-
gating fields, and harvesting fish and shellfish.

Clean water is needed for recreation — boating, swimming, camp-
ing and sport fishing.

Clean water is needed to support wildlife resources, not only
fish and other aquatic life but also animals and birds.

Clean water is needed for industry. Manufacturers of soft
drinks, beer and drugs frequently demand water of a very high
quality. Sueh industries as pulp and paper, phosphate processing,
agriculture, citrus processing and chemicals require large amounts
of water. During the past 25 years, the breakthrough of science
and technology has been greater than it was during the entire
period from the year 1 to 1940. Progress has demanded additional
uses of quality water in larger amounts than man has ever needed
before.

Overlapping Interests and Demands

The water resources of Florida belong to the people. However,
there are a number of groups who use the state's water resources
and each group is intent on gaining its own worthwhile goal.

— Providers of public water supply would like to maintain
every stream in a state of pristine purity without turbidity, color,
taste or bacteria so that water could be supplied to the public with
a minimum of treatment.

FLORIDA HEALTH NOTES • 7

— Nature lovers view every lake and river as a national treasure
to be guarded against trespassers.

— Those concerned with public waste disposal would like to
have access to any available stream for the disposal of wastes
with a minimum of treatment.

— Industrial users frequently require purer water for products
and industrial processes than is necessary for the usual public
water supply.

— Industrial establishments requiring waste disposal would
like to use the streams as a natural receiver of liquid wastes with
a minimum of treatment.

— Fish and wildlife conservation groups want every waterway
as a natural resource primarily for the propagation of fish and
wildlife.

— Agricultural interests want to irrigate all dry lands with
pure water and drain all wet lands without too much expense.

— Cattlemen object to elimination of waterways or the pol-
luting of water usable for livestock but also insist on their rights
to drain pasture lands.

— Electrical power interests value flowing streams as a po-
tential source of power and, in turn, want to put hot water from
generating plants back into the streams.

— Shipping interests maintain that the main function of
water is for shipping plus the receiving of bilge waters and
wastes from ships. 2

All of these claims are legitimate and each must be heard and
respected. But water is limited and many of the uses are not
compatible with another. To give priority to one use inevitably
means sacrifices of the other interests. Perhaps restricting use of
waters by zoning to compatible uses would be an answer.

What is Water Pollution?

Polluted water is the opposite of clean water. Although Flori-
da's pollution problem may not be as dramatic as that of other
areas, such as New Jersey, New York and the District of Colum-
bia, right now is the time to prevent further polluting of our clean
waters.

There are many definitions of water pollution. The sanitary
engineer has one definition; the lawyer has another; the layman

2- Lee. David B. Unpublished paper given at Twenty -First Annual Meeting of the Soil and
Water Conservation Supervisor*. Tampa, Florida. August IB, 1966.

8 • FLORIDA HEALTH NOTES

may have a third. A pollutant may be anything of a deleterious
nature added to water. Water pollution may be anything that has
been used for domestic and industrial purposes and channeled into
an uncontaminated stream thereby polluting the water and re-
ducing its usefulness. The act of polluting Florida's waterways
may be that of adding or emptying into a body of water anything
that makes it unsuitable for the purpose for which the water was
intended or makes the water uninhabitable for its natural aquatic
life.

There are Florida laws which make it unlawful for any rubbish,
filth, poisonous or noxious substances likely to affect the health
of persons, fish or livestock to be placed in or deposited where it
may be washed or otherwise admitted to any of the waters of the

state. 8

There are a number of pollution classifications listed by various
reports and authorities :

Sewage and other oxygen demanding wastes include organic
substances from domestic sewage and such industries as food
processing plants. These wastes are reduced to stable compounds

3. Florida Statuttt. Chsper 387.08, p. 190S-UM.

A youngster stirs up oily pollution in a Florida stream. Such pollutants
make streams unhealthy.

through the action of aerobic bacteria which require oxygen in
their life processes.

Infectious agents are in the wastes from municipalities, sana-
toria and certain kinds of industries, such as tanning or meat
processing plants, which contain human and animal wastes. These
organisms can cause such diseases as typhoid fever, virus infec-
tions and intestinal disorders in 'persons ingesting them directly
through drinking untreated water or indirectly through recrea-
tional activities.

Plant nutrients are stable mineral compounds which remain
after the oxygen-demanding organic wastes are removed by treat-
ment. These nutrients are introduced into streams in large amounts
through discharges from municipal sewage and industrial waste
plants, or leached from farmlands and citizens' lawns. The nutrients,
of which nitrogen and phosphorus are two important examples,
are used for food by aquatic plant life, such as algae and water
weeds.

Organic chemical exotics, such as detergents, insecticides, pesti-
cides and weed killers, are carried into water bodies with domestic
and industrial wastes, washed off vegetables and land surfaces or
introduced directly into the waters to control pests or rough fish.
Only a limited amount of these chemicals are removed from water,
either by sewage treatment plants or water purification plants.

Other mineral and chemical substances result from mining or
industrial processes, or from nature itself. They include a wide
variety of common salts, metals and metal compounds in solution
or as fine particles or acids. Some have very toxic effects.

Sediments, primarily from soils and lands washed by storm
and floodwaters, are not normally a primary concern of water
pollution agencies. But sediments are important because they re-
duce shellfish and fish spawning grounds and thus man's food sup-
plies. They reduce aquatic plants which are required in the process
of maintaining an adequate dissolved oxygen balance in water and
also plug water filters and erode pumping equipment.

Radioactive substances which are possible sources of water pol-
lution are significant because of three important factors ; the quan-

10

FLORIDA HEALTH NOTES

tity of material involved, the duration of waste discharge and the
degree of hazard associated with the specific radioisotopes involved.
Sources of radioactive substances may be waste products from
mining or refining of radioactive material or waste products from
power reactors for industrial, medical or research purposes which
have been allowed to escape.

Heat is a pollutant. Tremendous amounts of water are with-
drawn daily from streams and lakes for cooling' purposes by steam
electric power and other industrial plants. After use, these waters
are returned to the river or lake from which they were drawn.
Large amounts of heat are transferred to the waters, and since
the oxygen which the water holds in solution diminishes with in-
creasing temperature, the adding of heat cuts down the ability
of the waters to assimilate oxygen-demanding pollution or support
fish life.'

What Causes Water Pollution?

It is inevitable that the quality of water is altered with its use.
The control of pollution therefore is a problem of critical importance.
The method of control needs to vary with the degree and type of
pollution, and there are degrees of pollution.

— Natural pollution occurs when the water picks up impurities
from the earth's cover, its soil and minerals. The water is polluted
before man uses it.

— Permissible pollution is the planned use of the water re-
sources where effluent discharge is highly treated.

— Allowable limited pollution is the reasonable overloading
of streams which reduce the full usefulness of the water resources
for a limited zone without danger to other beneficial water users.

— Excessive or gross pollution is the misuse, destruction of the
water sources."

Water is essential for most of man's activities and one of its
important uses is the carrying away of waste materials of which
there are many kinds. Some materials can be handled in limited

*■ Kerr Report No. 0. Water Reaaure* Activitii* in tht UniUd Stat**. U. S. Government
Printing Office, I960.

ft. Florida' * Water Rttouret*. Report of the Florid* Water Resource Study Comnlaatan to
the Cover and 1B6T Legislature. Gainesville. Florida. 1»56. p. 62.

FLORIDA HEALTH NOTES • 11

The Importance of Florida's Waters

"Among Florida's major assets or natural resources are its sun-
shine, its climate, its water supplies, its streams, its lakes and its
shores, Florida sunshine is said to have a value of two billion dollars
a year as a tourist attraction. But even Death Valley has an abundance
of sunshine. So does the Sahara Desert. Neither are sought as places
to live, however, and it becomes immediately apparent that the great-
est of all Florida natural resources are its water supplies, including
its streams and its beaches. Without them, our sunshine and climate
would be of little value."

— Smith, David B., STREAMS IN FLORIDA, Florida Engineering
Series No. I, College of Engineering, University of Florida,
Gainesville, 1954. From the Preface by John E. Kiker, Jr.

amounts without damage to water resources. Some other types of
wastes can be treated satisfactorily before allowing them to enter
water resources without danger to the streams. Some inorganic
wastes of industry cannot be handled the same way as organic
wastes because they interfere with the treatment process and
therefore must be handled separately. Other wastes are toxic or
otherwise harmful. If wastes are dumped into water courses or
permitted to find their way into underground aquifers, they can
render water unsuitable for further use.

The natural activity of water provides some purification of
organic wastes because of its ability to assimilate waste. Inorganic
wastes are generally accumulative and are not quickly dissipated.
Unless safeguards against such wastes are installed, both man-
made and natural pollution tends to increase. The value of water
resources is limited by quality as well as quantity and heavily
polluted waters should never be used if other waters are available. 9

The main detrimental characteristics associated with the dis-
charge of untreated or inadequately treated sewage into surface
and underground waters are unhealthy concentrations of disease
bacteria, depletion of dissolved oxygen, unsightly floating solids

6. /bid. p. 62,

12

FLORIDA HEALTH NOTES

and turbidity, odors and stimulation of aquatic plant growth. The
most important use which might be limited by sewage pollution
is the use of water resources as public water supplies.

Wastes from industries are as varied and complex as the in-
dustries themselves. Such wastes may contain organic matter
similar to that found in sewage, or the wastes may contain other
materials, such as oils, acids, greases, chemicals and mineral salts.
Florida has a number of industries which have liquid wastes. These
are citrus processing, vegetable canning, meat processing, brewery,
milk products, crude sugar, mining, phosphate, chemicals, synthetic
fibers, acid and fertilizer, pulp and paper, pine tar extraction,
metal processing, tannery, oil and asphalt, fish oil, laundry and
weaving.

In the past, industrial wastes have been partly responsible for
the low oxygen content of tidal waters, streams and portions of
lakes and bays. Wastes no longer pollute many of these waters
because of the development of useful by-products and in-plant
process changes which have been most lucrative to some industries.
Waste treatment to permit the reuse of wash water in the phosphate
processing field, and treatment of citrus pulp to reduce pollution
potential and make fertilizer and animal food have done much to
eliminate previously important waste problems. 7

Authorization of the State Board of
Health and County Health Departments

Why is the State Board of Health interested in maintaining
clean water and controlling water pollution? Under Chapter 381
of Florida Statutes, it is authorized to "commence and maintain
all proper and necessary actions and proceedings to enjoin and
abate nuisances dangerous to the health of persons, fish and live-
stock . . ." 8 and ". . . to protect and preserve the public health."*

Chapter 154.01 of Florida Statutes gives counties and cities
the authorization to ". . . cooperate with the state board of health

7. Ibid pp. 64-68

B. Florida Statute*. Chapter B81.031(*Mb), p.lSBO

». Florida Statute: Chapter 381.03H4)(d>, p.lSBO.

FLORIDA HEALTH NOTES • 13

Some exotic pollutants, such as detergents, are not affected by processing
in a sewage treatment plant. The State Board of Health is trying to halt
the practice of allowing such effluents to flow into drainage ditches and
streams.

in the establishment and maintenance of f ulltime local health units
in such counties for the control and eradication of preventable
diseases, and inculcate modern scientific methods of hygiene, sani-
tation and the prevention of communicable diseases." 10

The State Board of Health has been given the job of super-
vising the control of water pollution in Chapter 387 which states:

"Any person, firm, company, corporation or association in
this state, or the managing agent of any person, firm, com-
pany, corporation or association in this state, or any duly elect-
ed, appointed or lawfully created state officer of this state, or
any duly elected, appointed or lawfully created officer of any
county, city, town, municipality or municipal government in
this state, who shall deposit, or who shall permit or allow any
person or persons in their employ or under their control, man-
agement or direction to deposit in any of the waters of the

10. Florida Statutt*. Chapter IM.01. p. 586.

14 • FLORIDA HEALTH NOTES

lakes, rivers, streams and ditches in this state, any rubbish,
filth or poisonous or deleterious substance or substances, liable
to affect the health of persons, fish or livestock, or place or
deposit any such deleterious substance or substances in any
place where the same may be washed or infiltrated into any
of the waters herein named, shall be deemed guilty of a mis-
demeanor and upon conviction thereof in any court of competent
jurisdiction, shall be fined in a sum not more than five hundred
dollars ; provided that the carrying into effect of the provisions
of this section shall be under the supervision of the state board
of health." 11

The State Legislatures of the past have declared that water
pollution is a health hazard and have given the State Board of
Health the authority to make broad policies concerning the control
of water pollution as it affects public health. Other state agencies,
such as the Game and Fresh Water Fish Commission, the State
Board of Conservation, State Soil Conservation Board, State De-
partment of Agriculture and many local governments have interests
in water control districts, waterway beautification projects, water
management programs, shellfish harvesting and other programs
which also enter into the water pollution control picture.

This issue of Florida Health Notes will tell you what the State
Board of Health and County Health Departments are doing to
protect the clean waters of Florida. While they have been given
the authority to supervise the control of water pollution, they
frequently have not had adequate resources to carry out their
programs. Much progress has been made in the past 20 years, but
there is much to be done. This issue of Health Notes also will tell
you what steps the State Board of Health is taking to enlarge
its program.

The Water Picture in Florida

Florida is a state of 58,560 square miles and contains some
30,000 lakes. Because of its peninsular shape, no part of the state
is farther than 70 miles from the Atlantic Ocean or Gulf of Mexi-

II. Florida Statuta. Chkpter 587.08, pp. 1903-1 »M.

FLORIDA HEALTH NOTES • 15

co. It has more shoreline than any other state, some 1200 miles
of genera] coastline and nearly 9000 miles of tidal shoreline.

About 24 per cent of the water received as rain moves to the
ocean via surface channels, and as it travels it forms 12 large
river basins and many small ones. Surface waters average 40 bil-
lion gallons flow each day with the larger important rivers, Apala-
chicola, Choctawhatchee, Escambia, Suwannee and St. Johns, con-
tributing some 88 per cent of the state's surface flow. In the
south, Lake Okeechobee, which at its normal stage covers 700
square miles, is a main focal point of the South Florida Flood Con-
trol District. The Peace River, which flows through the citrus
and phosphate belts, is important because of its use as a public
water supply for some cities and the depository of sewage plants'
effluent for other cities.

The course of a stream, the rapidity of flow, characteristics,
fitness for use and other factors determine the value of a stream
as a natural resource. Unlike many other states, which may have
to ration water in the near future because of increasing population,
industrial expansion and demands for recreational facilities, Flori-
da has an extraordinarily large supply of water and an equally
large and varied demand for water because of the state's year
around warm climate.

But according to Florida's Water Resources:

"There are some areas in Florida where gross pollution
exists, but in no case does gross pollution extend more than a
few miles, and a few cases can be cited where pollution is re-
stricting the total use of a stream for a beneficial purpose. It
can almost be said that Florida has no water so seriously pol-
luted that it cannot be recovered. These statements must be
qualified, however for there are eases where the uses are
partially restricted, and there are indications that these pollu-
tion conditions will become more serious unless corrective or
preventive action is taken." 12

The problem of water pollution is complicated by the fact that
Florida has a large tourist industry which is dependent upon the
state's natural climate and resources. Approximately 16 million
tourists visit the state each year and spend some $3 billion. These

12. Op. Cit. Florida Wattr Rnourcn. p. 62.

16 • FLORIDA HEALTH NOTES

visitors expect to find good fishing of all kinds, boating and bath-
ing facilities, picturesque lakes, streams and springs and clean
waters. The outdoor recreational facilities are perhaps the greatest
incentive that tourists have for coming to Florida each year.

The State Board of Health's Concern
About Water Quality and Pollution

The State Board of Health has been interested and concerned
about water quality in Florida for many years. The public water
supply, production of seafood and shellfish and cleanliness of public
bathing places are prime examples of areas in which the State
Board of Health has jurisdiction.

The growth of cities and their increasing amount of wastes, the
rise in the number of small motorboats and their sewage discharge,
and the expansion of harbors with their many commercial and
Naval ships and fishing boats have endangered the quality of
water.

Streams and lakes are usually in balance in nature. Fish and
other aquatic animals take in oxygen and give off carbon dioxide
which is absorbed by plants that in turn give off oxygen. When
pollution enters the waterway, the balance is upset.

The amount of pollution that a stream can absorb is limited
by the amount of oxygen available in the water. Oxygen is re-
quired for certain bacteria to live and these organisms digest and
render harmless sewage and other organic matter. Inorganics, such
as mineral salts and synthetic materials, are not affected by
natural purification processes. When too much waste is poured
into the stream, the oxygen is exhausted, all forms of life die, ex-
cept the non-oxygen-demanding bacteria, anaerobic, and the stream
becomes septic.

DOMESTIC SEWAGE

Florida's Expansion in Past 20 Years

At the same time that Florida is greatly dependent upon its
fourist trade for a large part of its economy, it is also becoming
irreatly urbanized and industrialized. The population has increased

FLORIDA HEALTH NOTES • 17

Florida has built some
1550 sewage treatment
plants, such as this one,
in the fight for clean
water. Much of the im-
petus has been provided
by the State Board of
Health.

over 1.7 million in the past 10 years and nearly four million in the
past two decades. Over 70 per cent of the people live in 1 1 counties
— Dade, Duval, Hillsborough, Pinellas, Broward, Brevard, Volusia,
Orange, Escambia, Polk and Palm Beach. Great concentrations of
people usually lead to domestic and industrial pollution.

Florida has been called the "septic tank state" in the past,
simply because this method of domestic waste disposal has been
widely used. While the population has increased to nearly six mil-
lion and 70 per cent of the population is urbanized, only 50 per
cent of the people are provided with sewers and adequate sewage
treatment.

Yet in spite of this, Florida is one of the leading states in
modern sewage treatment plant construction. In 1930, when the
population was 1.1 million, there were 20 sewage treatment plants
in the state. By the end of 1965, there were 1539 sewage treatment
plants in operation.

In 1946, the homes of eight per cent of the state's population
were connected to some kind of sewerage system. That year the
State Board of Health received and approved 34 sewerage projects
which cost an estimated $11 million. 18 By 1956, 43.8 per cent of the
population was on sewers; 272 plants were in operation and the
State Board of Health received and approved plans for 259 sewage
treatment plants estimated at $30.2 million. 14 During 1965, plans
for 822 projects costing an estimated $38.2 million were received
and approved by the State Board of Health 10 .

During the past 20 years, Florida has spent $626 million on
sewerage systems. A total of $473 million of this sum was spent
in the last decade. During this period, 1439 sewage treatment plants
were constructed serving over 648,000 persons, or approximately
37 per cent of the 10-year population growth of 1.7 million. It is
sad but true that during this time, 5008 privies and 317,436 septic
tanks were also installed, serving 1.1 million persons. 18

IS. Annua! Report. Florida State Board of Health, 1 918. p. 61.
U- Annual Report. Florida State Board of Health. 1956, p. 141.

15. /iHTiuaf Report. Florida State Board of Health. 1565. p. £25.

16. Tht Semeno* Problem. Unpublished paper bv Division of Waste Water and Division of
Special Services, Bureau of Sanitary Engineering, Florida State Board of Health. Pre-
sented at Urban Planning for Environmental Health Course. Sarasota, Florida, June 20,
MM,

FLORIDA HEALTH NOTES • 19

During the past two decades, many major bodies of water were
cleaned up through the untiring efforts of local interests and the
State Board of Health. Among these were Biscayne Bay in Dade
County and Lake Worth in Palm Beach County, Also, portions of
Tampa Bay in Hillsborough County, Sarasota Bay in Manatee
County and Bayou Chico in Escambia County have been cleaned
up through the construction of sewage or industrial waste treat-
ment plants.

In 1941, when the population of Miami was 172,172 persons,
the principal place for the disposal of domestic wastes for the city
was Biscayne Bay which received approximately 26 million gallons
of raw sewage a day. The State Board of Health made a study
that year and recommended the construction of one of two types
of sewage treatment plants.

At that time, there were "many sources of sewage other than
the Miami River. Of a total of 70 outfalls, 29 emptied into the
Miami River, 10 between Ricken backer and Venetian Causeways,
24 between Venetian Causeway and Bay Point along the Miami
shoreline and seven outside the study area." 17

In 1949, another study was made and the director of the Bureau
of Sanitary Engineering of the State Board of Health, recommend-
ed and urged the City Commissioners to proceed with the design-
ing, constructing and operating of an adequate collection system
and sewage treatment plant to alleviate the public health hazards
existing in Biscayne Bay. 18

In 1957, Miami started construction of a sewage treatment plant
on Virginia Key which had a design capacity of 47 million gallons
per day. This plant resulted in the diversion of 30 to 50 million
gallons of raw sewage each day and made most of Biscayne Bay

IT. McKutty. J. Kneeland. Reynold* Enat S. and Miller. 5i«mund M. "Ecological Effect! or
Sewajje Pollution In Biacayne Bar. Florida: Distribution of Coliform Bacteria, Chemical
Nutrients and Volume of Zooplankton." Biotopieal Publication in Water Poltution. Trann-
action, of At 195) Seminar. U. S. Department of Health, Education, and Welfare. Public
Health Service, Robert A. Taft Sanitary Engineering Center. Cincinnati, Ohio. p. 201.

18. Letter of transmittal, Biscay** Ban PoUntion Swrrmy. May tkrougk October 'tit. Bureau
of Sanitary Engineerine. Florida State Board of Health.

20

FLORIDA HEALTH NOTES

suitable for limited recreational activities, such as boating and
water skiing.

Lake Worth has also become a recreational area with the in-
stallation of sewage treatment plants in the communities along
the shores. Palm Beach has a sewage collection system with an
ocean outfall ; West Palm Beach has installed a complete treatment
facility with final chlorinated effluent being discharged into the
lake; Riviera Beach, Lake Park, the Village of North Palm Beach,
the community of Lake Worth and Boynton Beach have installed
sewers and treatment plants; Lantana is connected to the Lake
Worth sewerage facility. Prior to this time, many of these com-
munities were dumping untreated sewage directly into the lake.

A 1962 survey conducted by the State Board of Health found
that the sewer outfall to Lake Worth was limited to: highly
treated effluent from the West Palm Beach sewage treatment
plant, emergency overflow drains from various lift stations along
the shore of the lake, a number of storm sewers, and industrial
waste from one milk pasteurization plant."

While much progress has been made in the past 20 years, Flori-
da communities are continuing to build sewage collection and
treatment systems. The State Board of Health encourages such
construction by offering professional guidance and advice on a
regional and county level and approval of plans on the state level.

During 1966 construction or renovation of sewage treatment
systems was underway at Dania, North Miami, Auburndale, Eau
Gallie, Winter Haven, Bradenton, Fort Walton Beach and Talla-
hassee; construction was completed in such municipalities and/or
sanitary districts as Fort Lauderdale, South Palm Beach, Cape
Canaveral, Long Key Sanitary District, Blountstown, Holly Hill,
Lake Butler, Pahokee, Daytona Beach, Starke, St. Petersburg and
Dunnellon; plans were approved for Coral Gables, South Miami,
Opa Locka, Holmes Beach, St. Petersburg's main plant, Deerfield
Beach, Leesburg, Pensacola, Niceville, Marianna, Umatilla, Naples
and Winter Park.

19. Progrt** Rtport, Lak* Worth Sttrvty, JvirAugutt ttit. Bureau of Sanitary En«in«rin«.
Florid* State Board of Health.

FLORIDA HEALTH NOTES • 21

Domestic Effluent Discharge

With the construction of so many sewage treatment plants,
there must be some place to empty the treated effluent. All coun-
ties do not have access to salt water and thus the effluent must
be discharged into nearby freshwater streams. Waterways and
lakes must continue to function as the final place of disposal for

Water Sampling and Testing Doubles

The work of testing water samples has more than doubled during
the past decade. Over 354,000 water samples were analyzed in 1965
by the State Board of Health's Bureau of Laboratories and the engi-
neering laboratory of the Bureau of Sanitary Engineering as com-
pared with 152,000 examinations performed in 1955. These analyses
do not include the thousands of bacteriological water analyses made
each year by environmental health personnel in 11 of the County
Health Departments.

effluent, simply because there is nowhere else to put it. However,
the wastes must be engineered out of streams to the maximum
extent so that the waters can be used over and over again for all
purposes which water must serve.

Jacksonville and a few smaller cities discharge some 16.8 mil-
lion gallons of raw sewage each day into a few of Florida's streams.
At the same time, other communities are discharging over 450
million gallons per day of treated domestic sewage which has an
average biochemical oxygen demand (BOD) reduction of 70 per
cent. This 70 per cent compares most favorably with a nation-
wide average of 45 per cent BOD reduction.

The State Board of Health is looking for treatment devices
which will bring the BOD reduction to 100 per cent, but this will
take additional funds for research and installing the equipment.

Sewage Treatment is Necessary

At one time in Florida's history, when there were fewer peo-
ple, the streams and lakes were adequate to dilute the waste ma-
terial entering the streams. Today the theory of dilution does
not work because the increasing numbers of people and wide va-

22

FLORIDA HEALTH NOTES

riety of pollutants make it impossible for the waters to handle
the pollution.

During the past 20 years and through the efforts of the State
Board of Health, 1550 sewage treatment plants have been built and
the spread of water pollution curbed, despite increasing industrial
development and the rapid growth of the population. There are
many problem areas. One of the outstanding examples is that of
Jacksonville and the St. Johns River. A large percentage of the
waters of the state is not polluted and probably less than five to
10 per cent have any gross pollution.

In the late 1940's, the State Board of Health and the U. S.
Public Health Service made an extensive study of the St. Johns
River and recommended the construction of a sewage treatment

The City of Jacksonville dumps approximately 15 million gallons of raw
sewage a day into the St. Johns River. One of the outfalls is located near
these buildings on the waterfront. Plans are underway to relieve the situa-
tion.

■

FLORIDA HEALTH NOTES • 23

.

plant for the City of Jacksonville. Since that time, the State Board
of Health has tried to influence the city and surrounding suburbs
to end the pollution of the St. Johns.

In 1953, Jacksonville retained Dr. Abel Wolman of Johns Hop-
kins University, a consulting engineer of international reputation in
the field of water pollution, who stated that the city did not need
waste treatment for many years to come. An advocate of the
theory, "The solution of pollution is dilution," Dr. Wolman ex-
pressed the opinion that Jacksonville could dispose of its raw
sewage in the St. Johns River, because in the river that flowed
past its door was the largest volume of moving water in Florida.

In 1955, the consulting engineering firm of Metcalf and Eddy
of Boston, Massachusetts, filed a report and recommended a master
plan covering Jackson ville-Duval area which stated, "The substan-
tial elimination of the discharge of untreated sewage from the
City of Jacksonville into the St. Johns River and its tributaries
would not be needed until the fourth stage of the program." About
this time, Jacksonville requested the State Board of Health to ap-
prove the sewering of the northwest section of the city and the
piping of untreated waste into the river at the Main Street Bridge.

In spite of the opinion from these distinguished sources, the
State Board of Health and its Bureau of Sanitary Engineering
steadfastly rejected the proposed solutions to the problem. Jack-
sonville was notified that the Board would not approve such plans
and it would use all legal means to prevent further degradation
of the river. The city then planned a sewage treatment plant which
started operation in 1961 and now treats approximately five mil-
lion gallons of sewage a day. The plant has a capacity of treating
12 to 13 million gallons daily but the city lacks the sewers to carry
the water to the plant for treatment.

Plans are underway by Jacksonville to eliminate raw sewage
and some industrial waste from the St. Johns River and its tribu-
taries at an estimated cost of $25 to $30 million. This is the first
phase of the project. The State Board of Health, meanwhile, has

24

FLORIDA HEALTH NOTES

made more progress in Duval County by bringing about the con-
struction of some 80 large treatment plants. 30

INDUSTRIAL WASTE

A More Vexing Problem

As previously stated, industrial wastes are as complex and
varied as industry itself. Wastes put out by some industries are
organic and can be treated along with or in the same way as
domestic waste. But industries, such as paper and pulp and chemi-
cals which use large amounts of water, frequently are reflushing
the water with contaminated effluent. Many times these pollutants
cannot be treated the same way as domestic wastes and consequent-
ly the waste waters are let loose into a nearby ditch without treat-
ment. These waters then flow into larger ditches, streams and
rivers, contaminating the whole waterway system.

These pollutants are new to our waters. It is happening at a
time when the growth of cities and the boom in industry are
putting a strain on our water resources. Not only are we using
more water than before but we are also using it in more compli-
cated ways; and flushing it back dirty to be used over again by
the next user. The next man may drink it or use it to feed live-
stock, grow crops, raise fish or other products.

Industrial pollutants are found in many forms. Not only are
they found in washings from airplanes, citrus processing and milk
pasteurization plants and paper mills, but they are found in the
more exotic problem-products such as household detergents, farm
insecticides and wastes from plastic manufacturing. Radioactive
wastes are being carefully watched by such agencies as the Brevard
County Health Department and the State Board of Health's Radiol-
ogical Laboratory. Chemicals, minerals and stable compounds
which do not break down are of great significance in water pol-
lution control.

10. Appendix A. Letters between Bar L. Wilson and Wilson T. Sowder. M.D.

FLORIDA HEALTH NOTES • 25

Water in o dam is used for electrical, conservation and agricultural pur-
poses.

26 • FLORIDA HEALTH NOTES

There is a constant movement by the State Development Com-
mission, the Florida Chamber of Commerce, local chambers of
commerce and other groups to bring in industry. Many of the
industries which have come into the state in the past 10 years
have asked approval of the State Board of Health for their plans
for water use and waste treatment facilities prior to building.
Sometimes much money is required to install waste treatment fa-
cilities and many of the older industries have resisted efforts to
educate them to better waste control.

A total of 68 waste treatment plants for industries was approved
by the State Board of Health in 1965. Thirty -five of these were
coin-operated laundry facilities. Others were for phosphate process-
ing plants, plating mills, abattoirs and meat processing establish-
ments, milk and ice cream plants, printing establishments, car
wash installations, citrus processing plants and railroad yards. 21

While more industry waste treatment plants are being installed
every year, the State Board of Health's resources have not kept
pace. Every facility needs to be checked from time to time to
make certain that it is working properly. It has been impossible
to carry out such a program of regular inspection.

Industrial Pollution and Trouble Spots"

The State Board of Health, while handicapped by a shortage
of resources to keep up with Florida's expanding economy, has
taken corrective actions in many places of the state. These actions
were carried on through conferences, persuasion and conciliation
but sometimes legal action was necessary.

Some Duval County companies, which had been emptying wastes
into the Ribault and Cedar Rivers, installed treatment plants, oil
separators and sewers to clean up their operations. Another com-
pany was informed that its waste needed additional treatment
before entering the St. Johns River, and the City of Jacksonville
and a few industries were discharging untreated waste into Mc-
Coys Creek. Currently the State Board of Health is seeking in-

8$. Op. Cit. Annual Report, 19S5, p. SOT.

2!. Appendix B. Report from Vincent D. Patton.

FLORIDA HEALTH NOTES • 27

junctions against two companies which have unduly delayed action
on waste treatment.

In Dade County, a force main was installed which connected
the Miami International Airport to the City of Miami sewerage
system for the purpose of collecting and transporting wastes from
the airport and an industrial area. This main removed wastes
which would have gone into the ground near a well field.

In Putnam County, a pulp and paper company installed a pri-
mary clarifier and is working toward secondary treatment. Another
plant has installed new sewers connected to Palatka's sewage treat-
ment plant.

A new plating waste treatment plant has been installed at Cape
Kennedy in Brevard County. A Naval installation has put in treat-
ment for airplane washing facilities in Santa Rosa County and a
chemical company has reduced the strength of its wastes through
in-plant practices in order to prevent pollution of Escambia Bay.

Two companies in Escambia County, which previously were pol-
luting Bayou Chico, have installed treatment plants; another com-
pany installed settling basins and a lake to remove solids from its
wastes; a fourth company installed two deep disposal wells for
strong wastes and is working to reduce contamination of cooling
water. A Naval installation is working on a design for treatment
of its industrial waste.

The City of Leesburg in Lake County has expanded its sewage
treatment plant which will treat waste from a citrus concentration
operation. Two citrus processing companies in Orange County have
expanded their treatment facilities and stopped polluting a near-
by lake. Prosecution is pending against a third company as a
result of its failure to halt pollution.

Many treatment facilities have been installed for small plants,
such as laundries and meat packing plants. Several large estab-
lishments have installed facilities to treat wastes which would
otherwise cause pollution. These are located in Orlando, Bradenton,
Hamilton County and West Palm Beach.

28

FLORIDA HEALTH NOTES

Pollution from Agriculture

Agricultural interests are the largest users of water in Florida.
A great amount of water used in raising crops, pastures and groves
is not collected and transported to the place of use but falls as
rain. It would seem that in an area of abundant rainfall, such as
Florida, there would be sufficient moisture, but the vagaries of
nature do not always supply rainfall as needed and there are
periods of normal, wet and drought years. Therefore, irrigation
is becoming increasingly important to supply moisture during dry
periods.

The extensive use of phosphate and other inorganic fertilizers,
and insecticides, herbicides and pesticides used in spraying or
dusting crops and nuisance plants are washed into streams in the
same manner as silt where land management is not practiced.
When fertilizers and phosphates are washed into streams, they
supply food for algae, an aquatic plant which through varying de-
grees of sunlight can make the oxygen content of the waters
fluctuate. Extreme changes in oxygen content can kill many forms
of aquatic life. At times, residents along the Peace River have
objected to "pollution" which was in reality a large bloom of algae.

Insecticides, herbicides and pesticides are called exotic pol-
lutants and are hard to dissipate in water, sometimes turning up
in public water supplies.

Not only are waters of the state polluted from poor land man-
agement, but they are also frequently dirtied by wastes from live-
stock. One cow gives off as much waste material as 16.4 humans.
One hog creates as much pollution as 1.9 humans and seven chick-
ens can equal one adult. Farm animals in the United States pro-
duce 10 times as much waste as the human population. One rural
ditch in South Florida was discovered by County Health Depart-
ment sanitarians to have wastes six feet deep from a nearby barn. 23

In one of the largest milk production areas of the state, the
County Health Officer of Okeechobee County and his sanitarians
did something to circumvent this type of pollution. They worked

23. Op. Cit. Lee, D.vid B.

FLORIDA HEALTH NOTES • 29

AREAS OF POLLUTION, FLORIDA 1947

Pen

□

o

INDUSTRIAL POLLUTION
POLLUTED AREAS

Twenty years ago < above), there were few sewage treatment plants and
much pollution in Florida. Today, only about five to 10 per cent of the
surface waters of Florida hove any gross pollution. The waters of Taylor
and Nassau Counties {opposite! have been declared by past Legislatures
to be industrial rivers.

out with the dairy farmers and industry a method of salvaging
barn wastes in a semi-liquid form and placing this material back
on the ground to serve as an organic soil builder and plant food
nutrient. At one of the state's largest dairy and beef production
farms, special type pits were constructed into which all of the

30

FLORIDA HEALTH NOTES

AREAS OF POLLUTION, FLORIDA 1967

St .Johns
River

Cast Pensacola Bay

Lake

Apopka

INDUSTRIAL WASTE

LOCATIONS OP DOMESTIC WASTE

Everglades-

barn wastes were accumulated. These semi-liquid wastes were
then pumped into a mobile tank and transported to the fields for
spraying.

Several benefits were derived from this method of barn waste
disposal: These wastes were eliminated as a source of pollution
of natural waters; a tremendous amount of organic material and

FLORIDA HEALTH NOTES

31

Lee Received National Water Pollution Control Award

The director of the Florida State Board of Health's Bureau of
Sanitary Engineering, David B. Lee, received the Chorles Alvtn
Emerson Award from the Wafer Pollution Control Federation on Sep-
tember 29, 1966, in Kansas City, Missouri.

The award was made to Mr. Lee for his outstanding service to the
Federation and his excellence in the field of public relations and legis-
lation as they relate to water pollution control. In over 34 years of
engineering service with the State Board of Health, Mr. Lee has applied
his knowledge and administrative ability to water pollution control in
Florida and the nation. The award honors the first president of the
organization who was a distinguished consulting engineer.

plant nutrients was salvaged; odors were minimized, preventing
a sanitary nuisance; fly and other insect breeding places were
eliminated ; and a large saving in the cost of fertilizers for pastures
was realized.

State Institutions and Pollution

While the State of Florida has been telling industries and mu-
nicipalities to control or eliminate their pollution, it is also neces-
sary for the state to look at its own physical plants to make sure
that these institutions are not causing pollution. During a sur-
vey of the Apalachicola River in June and July 1964, by regional
engineers of the State Board of Health, samples collected indicated
a concentration of E. coli being discharged from the State Hospital
at Chattahoochee.

An investigation was conducted for possible sources of pollu-
tion and indications were that the hospital laundry was the con-
tributing factor. To evaluate fully the laundry, a series of samples
were collected and field measurements made of the flow from the
laundry area and other facilities. It was determined that a com-
bination of flows discharged into the common outfall of the hos-

32

FLORIDA HEALTH NOTES

pital property. This total outfall included the sewage treatment
plant discharge and combined laundry and storm sewer lines.
Further investigation of the combined lines indicated that the
following facilities contributed to the total flow: backwash water
from the water plant, excess raw water not used in the water plant,
cooling water from the ice plant, blowdown water from the steam
plant, and fly ash and dust collection waste water from the steam
plant.

Surveys made at sewage treatment plants at other state in-
stitutions showed that some of the installations needed:

* tertiary treatment to obtain a higher degree of treatment,

* complete engineering study and evaluation of sewerage sys-
tems,

* improved operation and maintenance,

* laboratory equipment provided in order to make analyses
recommended by the State Board of Health for better opera-
tion,

* BOD incubator,

* connection of sewage treatment plant to city or district
sewerage system,

* routine analyses of plant operations,

* treatment of laundry wastes,

* filter renovation,

* enclosed outfall line laid to a primary canal, and

* ownership of plant determined and adequate treatment pro-
vided for eliminating the discharge of raw sewage. 2 *

Recent federal activities have required the individual states
to look at their own programs, improve their facilities and eliminate
any unsuitable practices as it is just a matter of time before the
Federal Government through the U. S. Department of Interior
will be checking these facilities. It would be better for the state
to review its own needs, strengths and weaknesses, at all of the
state institutions and state-owned sewage treatment facilities than
to have the Federal Government point these problems out. Often
the weaknesses could be attributed to the practice of slashing
allocated budgets for waste treatment facilities prior to construc-
tion. Consideration should be given to standardization of new

2*. Rtport on State Inttitutiom*. 1966. Bureau of Smnitanr Engineer! n«, Florida State Board or
Health.

FLORIDA HEALTH NOTES • 33

treatment works in line with new and modern technology of waste
treatment facilities. 25

ACTIVITIES OF THE

STATE BOARD OF HEALTH AND

COUNTY HEALTH DEPARTMENTS

Each year the State Board of Health, its Bureau of Sanitary
Engineering and County Health Departments receive many com-
plaints of odors from streams and ditches, fish kills, polluted lakes
and streams and other kinds of annoyances. Many people base their
complaints on odor, sight or some other sensory perception and
not on a scientific basis. Sometimes they have grounds for their
complaints and at other times what they think is pollution may
be a natural condition. Frequently, the same people expect "in-
stant enforcement" at no cost to the taxpayers.

Every complaint is investigated by the county or regional
sanitary engineer or sanitarian. Perhaps the situation is already
known, under investigation and checked out. A written report is
submitted by the engineers and recommendations made as to how
to correct a pollution situation, if one does exist. Steps are made
to alleviate the pollution problem by conferences between the
State Board of Health engineers and all the polluters.

The County Health Departments are under the supervision and
direction of the State Board of Health and there is a close working
relationship between the agencies in the field of water pollution
control.

Chapter 154.04 of Florida Statutes reads as follows:

"Such employees shall devote their entire time to the control
of preventable diseases and the education of the public in
modern scientific methods of sanitation, hygiene and the con-

25. Baker. Ralph H., Jr. Litter of Trammitta), Report on Stat* Inttitulicxt. Augnit IS, 1966.
Bureau of Sanitary Engineering, Florida State Board of Health.

34

FLORIDA HEALTH NOTES

trol of communicable diseases in cooperation with and under
the supervision of the State Board of Health." 1 *

Among other programs, the State Board of Health and County
Health Departments are responsible for the prevention of unsafe
shellfish being harvested and reaching the consumer. To carry out
this program, sanitary quality of growing water areas are de-
termined by the Bureau of Sanitary Engineering with samples of
water and shellfish examined by the State Board of Health labora-
tories. The sanitary inspection of seafood processing establishments
and enforcement of sanitary regulations are the routine function
of the County Health Department, with the exception of Franklin
County which has inspection by a sanitarian attached to the State
Board of Health's marine laboratory.

The U. S. Public Health Service annually evaluates the State
Board of Health's program to determine to what extent it meets
the standard set up by that federal agency. Shellfish growing
areas are reappraised biannually to assess new pollution sources
or any significant changes on the various watersheds. The control
of water pollution is essential to the thriving shellfish and Crustacea
industries.

Northeast Florida Region

It is true. Streams that were polluted 20 years ago are polluted
today, but stream pollution is not more acute than it was two de-
cades ago. Most of these streams, such as the St. Johns River,
will within the next few years improve considerably under the
State Board of Health's unrelenting program of surveillance and
constant pressure on industries and municipalities.

Twenty years ago there were no adequate sewage treatment
plants in the region. Today there are 120 sewage treatment plants
serving subdivisions and cities.

There has been less progress in the treating of industrial wastes
as compared to providing domestic waste facilities. There are sev-
eral reasons for this condition: Industries in the past have moved

M. Florida Statute/, Charter 1M.M. p. MS.

FLORIDA HEALTH NOTES • 35

The State Board of Health
investigates every complaint
of "fish kill" in the fight to
control water pollution. The
fish were killed by pollution
in Duval County's Cedar
Creek on October 13, 1966.

36

FLORIDA HEALTH NOTES

into the region and started production without knowledge of the
State Board of Health; other industries have come in and tied
into existing sewer lines that discharge untreated wastes into
streams; and other industries have come in and provided some
treatment devices which were operated for awhile and then by-
passed when the facilities were found to be inadequate due to
plant expansion or when the cost of operation and expansion of
facilities were considered unwarranted by the industry. 2 *

Central Florida Region

Definite progress has been made in the 11 counties of this
region in the last 10 to 12 years and particularly in the past five
years. At the present only two municipalities in the region are
discharging inadequately treated sewage into surface waters. One
is Crystal River; however, plans have been approved in this mu-
nicipality for a secondary treatment facility and financing is the
only hurdle to be overcome before construction starts. Cedar Key,
the second municipality, is planning toward adequate treatment
facilities.

Twenty years ago Imhoff tanks, which gave some sewage treat-
ment, were in operation at Orlando, Ocala, Leesburg and Winter
Park. Such a tank is located at Crystal River, but it gives poor
treatment. In the past eight years, approximately 30 sewage collec-
tion and/or treatment plants were constructed and/or enlarged
in the region. Several municipalities, which are presently served
by individual septic tanks, have had or are in the process of having
engineering reports prepared which could ultimately lead to sewage
collection and treatment facilities within the next few years.

The greatest problems are areas outside of municipalities where
septic tanks serve large concentrations of populations. Should these
areas be annexed by municipalities, where sewage treatment can
be provided, or be formed into county sewer districts, the problem
would be alleviated. Several hundred small or packaged sewage
treatment plants have been installed to serve subdivisions, motels,

27. Appendix C-l. Report from Nick Maatro.

FLORIDA HEALTH NOTES • 37

shopping centers, trailer parks, camps and camp grounds and other
types of individual installations.

Although progress has been made in industrial waste disposal
in the Central Region, many of the citrus processing plants con-
tinue to dump their wastes without treatment. Another threat to
surface waters, especially where there are swamps adjacent to
open water, is the polluting of water resources by muck farm
operations. 28

Southwest Florida Region

Fifteen years ago there were only three sewage treatment
plants in the area, one municipal plant at Sarasota and two at a
military hospital. In the past five years, an average of 65.8
sewerage projects each year were constructed at an average yearly
cost of over $2.3 million.

At the present time, two municipalities in the eight-county
region are dumping untreated wastes into Florida's streams. They
are LaBelle, which is soon to start construction of a sewage treat-
ment plant, and Everglades, which has had plans for a sewage
disposal facility but has not begun construction because the City
Commission has passed a resolution indicating that it will not
build the plant. The State Board of Health has therefore instructed
its legal department to initiate appropriate action against Ever-
glades. There have been septic tank failures in Charlotte Harbor
and Englewood areas and dumping of raw sewage into the Caloosa-
hatchee River east of Fort Myers.

In the past 15 years, a total of $28.7 million has been spent
on domestic sewage facilities in the Southwest Region and over
$560,000 on industrial waste treatment. There is much progress
in the field of industrial waste because there are fewer installations
involved. There are no substitutes available for treatment of in-
dustrial waste, such as several septic tanks for sewage treatment
plants and the promotion of air and water pollution programs by
the State Board of Health and the Federal Government. 29

!8. Appendix C-2. Report from G. W. Folk*.
28. Appendix C-S. Report from E. M. Larsen.

38

FLORIDA HEALTH NOTES

Southeast Florida Region

Water pollution in the agricultural counties of South Florida
is a problem because the growing dairy industry has difficulty
in disposing of barn wastes. Some progress has been made in the
field of municipal waste treatment in Martin, St. Lucie, Indian
River and Highlands Counties. A number of outfalls discharging
into the Indian River have been removed but there is a continuing
use of septic tanks. The problems from citrus processing waste
could increase as groves go into production and there is a new
problem of sedimentation in the saline estuaries from expanding
drainage works.

Package treatment plants have been built in larger in-
stallations in the Keys and in many cases effluent from these
plants are being reclaimed for irrigation purposes. Tidal flush
cesspools are being supplanted by septic tanks with a modified
sand filter drainfield. These systems have not been successful
because of the bootlegging of local calcite material as sand.

Industrial waste is not a significant problem in the Southeast
Florida Region with the exception of laundry wastes. There are
still zones of pollution along the shorelines, but the zones need
clarification before the sources of pollution can be determined. 90

Dade County

In 1950 there were only two or three small sewage treatment
plants serving isolated areas of Dade County. Portions of Miami
were sewered but the city was discharging wastes into Biscayne
Bay and local rivers through 70 sewer outfalls. Through repeated
surveys and warnings from the State Board of Health, the voters
passed a bond issue which resulted in the removal of the sources
of pollution.

Since 1954, there have been 75 sewage treatment plants con-
structed with sewage collection lines serving the adjoining areas.
It is estimated that a permanent population of 564,000 persons is

30. Appendix C-4. Report from Richard Starr.

FLORIDA HEALTH NOTES

39

served by public sewerage systems which represent about 46 per
cent of the Dade County population.

The county and several municipalities have applied for federal
grants to install sewage collection systems and transmission mains
which will help remove pollution from many areas. There are
many difficult problems ahead before a unified sanitary sewerage
and disposal system can be constructed to serve the Metropolitan
Dade County area. The estimated cost of the first phase of the
project envisioned to be completed before 1970 has been set at
$100 million. 81

Broward County

In 1947, the population of Broward County was 69,000 where
today it stands at nearly half a million. The main water pollution
threat comes from some 85,000 septic tanks in the county, and
because of these the coliform count in the county's tidal canals
is higher than desired.

The county has moved into a county utility system aimed at
consolidating water and sewer facilities in the unincorporated
areas. Fort Lauderdale is planning a master sanitary sewer pro-
gram which will provide sanitary sewers for all of the city resi-
dents as soon as engineering and monies are available. The City
of Hollywood is planning a 10,000-foot ocean outfall which
will accommodate the present 87,000 population and the 18,000 resi-
dents of Hallandale. Pompano Beach possesses an ocean outfall
which accommodates all of the citizens of the Pompano Beach
Greater Reserve Area.

Today, the Broward County Health Department is responsible
for the inspection of 40 public water systems and 65 waste water
systems. 31

SI. Appendix D-l. Report from R. L. Quick.
32. Appendix D-2. Report from G. T. Lohmeyer.

• FLORIDA HEALTH NOTES

40

Manatee County

In 1946, the estimated population of Manatee County was
25,000 with one military sewage treatment facility constructed at
the airport during World War Two. The capacity of this facility
was 15,600 gallons per day. Three municipal sanitary sewer systems
were discharging untreated wastes into the Manatee River or
Wares Creek.

The first survey was conducted in late 1947 and gross pollu-
tion was evident. Since that time, sewage treatment systems were
built in Bradenton and Palmetto which have a total design ca-
pacity of 4.4 million gallons per day. Out of the other 85 sewage
treatment plants in the county, 11 serve subdivisions and the
remaining serve commercial establishments, such as trailer parks,
shopping centers and restaurants. In addition, there are industrial
waste water treatment facilities which serve a milk processing
plant and commercial laundries.

A new pollution control program is in operation in the county.
Water samples have been collected from Bishop's Harbor to de-
termine the possible effect that discharge from the Borden phos-
phate complex may have on waters of the area in the future. A
routine sampling of Sarasota Bay and monitoring of Ward Lake
and the Braden River are maintained as part of the pollution net-
work in the county. Samples of water have been collected and
analyzed from wells in the vicinity of the new Borden complex
to determine the effect of Borden's gypsum ponds on the under-
ground water supply. 88

Hillsborough County

In 1946, Hillsborough had no approved central sewerage system
and no approved waste treatment plants. Today, 296,085 persons
are served by municipal or private systems and there are 97 sewage
treatment plants. Of the three incorporated municipalities, 85 per

33. Appendix D-3. Reports from Frank L. Cross. Allen Kretsehmar and Georae Dame, H.D.

FLORIDA HEALTH NOTES • 41

cent of Tampa is served by sewerage systems; 95 per eent of
Temple Terrace ; and 80 per cent of Plant City.

Of the 127 schools, which have approximately 100,000 students,
only 12 are not on sanitary sewers or have their own approved
aerobic sewage treatment plants. Several of the 12 remaining
schools on septic tanks will be provided with sewage treatment
plants in the near future.

A meat processing plant, which in 1946 was dumping its un-
treated waste into the Palm River, has been connected to the
Tampa sewerage system which alleviates an acute pollution prob-
lem. The same company has built a large meat packing plant
near Plant City and constructed a waste treatment plant utilizing
the latest technological advances. 34

Pinellas County

Twenty years ago, the majority of populated areas of Pinellas
County was served by municipal and individual septic tanks with
some of the cities having sewers only in downtown areas. Since
that time 90 per cent of the population of 430,000 has access to
sewer systems and public water supplies. The sewage treatment
plants and connecting sewers were installed at a cost of $77 mil-
lion. A big step in putting 90 per cent of the population on sewers
was the formation of seven sanitary districts which serve many
small communities and subdivisions.

Industrial waste is not a big problem in Pinellas County since
the residents are mostly retired families and tourists and the area
does not depend upon industry for its economy. Some light in-
dustry is present and the major source of industrial waste is from
small plating companies. 85

34. Appendix D-4. Report from D. W. Rogers.

35. Appendix D-i. Report from Harold Lead better.

42 • FLORIDA HEALTH NOTES

Palm Beach County

During the past 20 years significant progress has been made
in the extension of municipal sewage treatment and the upgrading
of new and existing treatment facilities to tertiary treatment or
ocean outfall systems.

Progress has been made in Palm Beach County in the curtail-
ment of subdivisions on septic tank systems and discharging of in-
dustrial waste. Reported areas of need are countywide planning,
expansion of staff and personnel of the County Health Department
to meet the growing needs of the county, legal assistance on a
county level and the upgrading of privately owned sewerage fa-
cilities. 3 "

Water Pollution is a Health Problem

"The mass of population in great conurbations, coupled with
ever advancing ideas about hygiene and cleanliness, has made water
supply one of the major features of modern civilization. ,,ar

The public health aspects of water pollution relate to man's
drinking water ; to* his contact with water in recreation and work ;
to the contamination of food sources, particularly shellfish ; and to
the breeding of specific insect vectors of disease. These problems
of water pollution are the concern of public health and governmental
officials.**

It was not long ago that water-borne epidemics were common-
place. The scourges of typhoid fever and cholera during the middle
and late 1800's in America carried thousands of persons to their
death. In parts of the world these diseases, particularly cholera,
and also amebiasis, continue rampant today. In the Western Hemis-
phere, shigellosis, schistosomiasis, leptospirosis, paragon iniasis,
'iracontiasis and dysentery still continue to take heavy tolls among
people using polluted waters for drinking and bathing. Because

Appendix D-S. Report from Lawrence D. Lukin.

M»e»n, T. T. and Worthinnon. E. B. Lift tit Lakmm and Rivrrm. Collin* of
P. S3",

Appendix E. Health Aiptctt of Water Pollution Control.

FLORIDA HEALTH NOTES

IS St.

43

of modern methods of sewage disposal and their widespread use,
these water-borne bacterial and parasitic diseases are rare or ab-
sent from Florida and the United States. As long as there is
pollution, however, the danger is never completely absent. Water
can be a dangerous substance.

The possibility that certain disease-causing viruses may pass
from man to man through the water he uses has received increasing
attention during recent years. Water polluted with human waste
has played a prominent role in several poliomyelitis epidemics. A
relationship between certain epidemics of infectious hepatitis and
polluted water seems certain. Similarly, specific outbreaks of in-
clusion conjunctivitis, herpangina, epidemic myocarditis, epidemic
pleurodynia, summer diarrhea and other infectious gastroentri tides
have been traced to contaminated (polluted) water.

Besides these overt threats to the human health by polluted
water, there are also the nuisance factors. Pollution by its nature
increases the nutritive elements in water resources. This lends
to increased mosquito breeding and larger broods of all species
native to the polluted area. This alone would cause increased human
discomfort, from such insects as "blind mosquitoes," but also large
numbers of mosquitoes are ecologically related to outbreaks of
mosquito-borne encephalitis — a real threat to human health and
comfort.

Health is not simply the absence of disease or infirmity, but
the presence of a sense of well-being. Certainly, polluted water

WATER-BORNE DISEASES

Some of the important diseases which can be contracted from
polluted waters ore: amebiasis, ascariasis, cholera, clonorchiasts
'Asiatic liver fluke), inclusion conjunctivitis, diphillabathriasis, dra-
contiasis, echinococcosis, fasciclopsiasis. Salmonellosis, infectious hepa-
titis, leptospirosis, paragonimiasis, paratyphoid fever, pleurodynia,
poliomyelitis, schistosomiasis, shigellosis and typhoid and virus.

44

FLORIDA HEALTH NOTES

does affect the esthetic value of man, to include his desires and
needs for recreation which is a major use of Florida's waters.

STATE BOARD OF HEALTH'S
RESOURCE PROBLEMS

Personnel and Finances

The State Board of Health is admirably equipped in many ways
to carry out the job of controlling water pollution. It is a highly
capable agency — reported to be one of the' best five of its kind
in the United States. 33 However, it is having some paralyzing per-
sonnel problems.

At the end of 1965, the Bureau of Sanitary Engineering had
31 sanitary engineers and two sanitarians on its staff. There are
consistently a number of engineer vacancies which the State Board
of Health has been unable to fill because of low salary schedules.
As of October 1966, there were 10 open positions. About 75 per
cent of the staff spends all or part of its time on stream pollution
control.- 10 The present methods of fire-fighting operation and of
processing plans for sewage treatment and industrial waste plants
without adequate follow-up are not operating the water pollution
programs in the best interest of the citizens of Florida.

The State Board of Health needs personnel and monies to pro-
vide continuing surveillance of some 3000 public works facilities
such as air, water and industrial waste. The budget requirements
for the State Board of Health to carry out its statutory responsi-
bilities would be less than the loss and replacement of the phyai-

19. Bnlvak. John. than. Wall Strtel Journal < New York). January IS. 1966.

It. Patlon, Vlnctnt D. Unpubtlahed piper presented before the Florid* Chapter. American
Public Worki Association. Sixth Annual Convention, Tampa. Florida, May S. 1MM.

FLORIDA HEALTH NOTES

45

cal facilities should they be operated and maintained in an in-
adequate manner.

An estimated $250,000 of the Bureau of Sanitary Engineering
annual budget is spent on stream pollution activities, with an ad-
ditional $120,000 per year being supplemented from federal water
pollution control sources.

The Lack of Engineers

The State Board of Health is competing on a nationwide market
for sanitary engineers. Recruiters from industry and many areas
of government come to Florida and entice our graduates to other
states with higher salaries and greater benefits. It is a case of
national demand versus national supply and the State Board of
Health's personnel files document the recruiting results with such
comments :

"I appreciate the consideration . . . however, I have accepted
a position elsewhere." D. R. H., applicant from University of
Michigan.

"I fully intended to enter public health work of one sort or
another . . . but quite frankly, I received an offer from industry
that was too good to resist." R. W. G., applicant from Washington
University.

"After considering your offer, 1 have decided not to accept . . ."
R. L. D., applicant from West Virginia University.'* 1

Budget Requests

The rapidly increasing population, which will soon exceed six
million, and the accompanying industrial growth, requires bold

41. Austin, Mark. Unpublished paper, "The Scare Engineers." Florida Stat* Board of Health.
1968.

46

FLORIDA HEALTH NOTES

Stote Board of Health's sanitary engineers check the amount of pollution
in a roadside ditch.

action by the State Board of Health and the State Legislature to
effectively correct today's pollution problems and to prevent future
threats to the state's treasured environmental assets.

To meet the needs of the State Board of Health in this field,
it is asking the State Legislature for approximately $5 million for
the 1967-69 biennium. About $1.5 million of this amount would be
used for anti-pollution programs by County Health Departments.
This grant-in-aid program is new and should be a highly effective
Tiethod for the state to both stimulate local concern for air and
•vater pollution and share in meeting the local financial burdens
f operating good control programs on a local level. An additional

FLORIDA HEALTH NOTES

47

$1.5 million in local matching funds would give the program a total
sum of $6,5 million.

The State Board of Health is asking for two new attorneys to
handle the increasing needs for enforcing the anti-pollution laws.
In addition, 45 new positions have been requested for sanitary
engineers, chemists, laboratory technicians, biologists, sanitarians
and other personnel to bring an end to the pollution the state has
now and prevent future pollution.

Legal Aspects of Water Pollution

Many people who complain about pollution say, "Let's pass a
law ..." and expect that this will end the pollution problems.

Florida now has adequate laws to control pollution and only
minor changes are needed to make these laws most satisfactory.
The State Board of Health needs a more strongly implemented
water pollution control program to control and protect all legitimate
users of water resources. Equitable use of water resources should
be determined by professional engineers so that tourism, agricul-
ture, industry and conservation interests may use the total en-
vironmental resources of the state.

The State Board of Health lacks the legal staff to adequately
enforce the laws on the books. Enforcement is deficient because
resources are not available for proper surveillance of domestic and
industrial waste disposal facilities nor to provide the legal and
scientific staffs to put the programs into full effect.

There are two areas of the state which have been removed
from the jurisdiction of the Stae Board of Health by special acts
of the Florida Legislature.* 2 By these acts, Nassau and Taylor
Counties were declared to be industrial counties and the acts state
that it is in the interest of the public that industry be empowered
to discharge industrial and chemical wastes into the tidal waters
of Nassau County and into the Fenholloway Biver and the Gulf

42. Florida Special Acts 1941, c. 21415: Florida Special AcU 194 T. c. 2-1962.

48 • FLORIDA HEALTH NOTES

of Mexico into which the Fenholloway flows from Taylor County.

"If attacked, the legislation might be held unconstitutional
on the grounds that it deprives the riparian owners on these
waters of property rights without compensation in violation of
the state and federal constitution," 43

Legal Action by the State Board of Health

Below are some of the more than 62 legal actions taken by the
State Board of Health on behalf of the citizens of Florida since
1958 in relation to water pollution control. Some of the cases are
still pending; others were dismissed because of lack of conclusive
evidence or because of a release by another agency; other cases
were not pressed because the situations had been corrected ; or the
county solicitor did not press the case.

State of Florida ex rel Sowder vs. American Cyanamid Company

Stream pollution of Turkey Creek, Alafia River and Lithania
Springs occurred on February 5, 1965. A dike adjacent to waters
of the State of Florida ruptured discharging over 35 million cubic
feet of water containing phosphate waste. DISPOSITION: Injunc-
tion suit sought March 4, 1965, by State Board of Health to require
control of company facilities adjacent to state waters. This case
dismissed by Circuit Court on basis of a release by director of
Florida Game and Fresh Water Fish Commission. Damages of
$20,000 were paid to the Commission by the company on March
12, 1965.

State Board of Health vs. V-C Chemical Company, a division of
Socony Mobil Oil Company, Inc.

Stream pollution of Peace Kiver occurred on October 26, 1964.
Company negligently maintained a wooden overflow structure in
slime pond. It collapsed and two to five "acre feet" of phosphate
slime were released into the Peace River. DISPOSITION: Referred
to Polk County Solicitor on January 29, 1965; Solicitor advised

; 3. Op. Cit. Florida'* Water Reatntrcet. pp. 8-9.

FLORIDA HEALTH NOTES

49

I

1

State Board of Health that "prosecution not justified" on January
13, 1966.

State Board of Health ex rel Sowder vs. Container
Wire Products Company

Water pollution occurred on Ribault River and Cedar Creek in
Duval County. Company has failed to meet approval of State Board
of Health for waste treatment pursuant to orders of the agency
of September 14, 1966. Suit filed by agency on September 16, 1966,
requesting injunction to hold up operation until treatment devices
are built.

State Board of Health vs. Sloan Rental, Inc.

Criminal action was taken against this development of eight
rental units at Tavernier in the Keys. Developer was utilizing
dynamited holes in coral for discharge of human wastes. Under
direction of legal staff, dye tests indicated pollution into tidal
waters surrounding this Key. After extended period of time, the
Court found the defendant corporation and its president guilty,
giving him 30 days to remove the rental units, which consisted
of 16 X 16 foot plywood shacks. Removal was effected and case
closed.

State Board of Health vs. Lovering and Cran field

Case taken before County Judge's Court in 1961 in Manatee
County involved a chicken canning plant north of Palmetto. Un-
approved waste treatment with holding ponds was adjacent to
McMullin Creek, a tributary of Terra Ceda Bay tidal basin. Samples
taken under the direction of State Board of Health attorney indi-
cated salmonella present in holding basin and adjacent tidal waters.
The company was ordex-ed to close down, which resulted in termina-
tion of a $50,000 government contract on canned chicken for the
U. S. Army and subsequent bankruptcy of the company. The com-
pany has reorganized and is currently in operation utilizing ap-
proved facilities and has recovered its previous losses.

Are We Willing to Pay for What We Want?

Only about five to 10 per cent of Florida's waters are polluted
but more streams, lakes and springs will become "dirty waters"

50 • FLORIDA HEALTH NOTES

unless the State Board of Health is given the additional resources
to control pollution.

Howard W. Chapman, associate regional health director for
environmental health services of the U. S. Public Health Service,
states that Florida needs a ". . . minimum staff of 58 persons, but
a staff of 93 persons for its water pollution control program would
be more desirable. To support this staff, a minimum annual budget
of $528,000 would be required, and a desirable budget of $847,000.
Florida's present staff and budget is less than one-half of the
minimum recommended." These figures do not reflect the 356
environmental health personnel of the County Health Departments
who are involved in local program nor local budgets.

Mr. Chapman further said that the State Board of Health has
done an excellent job in obtaining treatment of wastes from mu-
nicipalities. The statistics on the number of municipal waste treat-
ment plants built in Florida during the last few years are im-
pressive. Between 1961 and 1965, 1003 separate treatment plants
were approved for construction. No state in the southeast region
of the United States, and only a few nationally, have had the rate
of population growth and urban expansion, with its accompanying
municipal waste problems, as has Florida.

The State Board of Health has an effective water pollution
control program which has done much to control or minimize
pollution in the state. To cope with the pollution problems as-
sociated with the population growth, urban and industrial ex-
pansion, the following is needed by the State Board of Health :

* Strong legislation providing all the consolidated authority
to do a complete job;

* Adequate budget and staff, and

* Long range planning for water pollution control to be initiated
which includes a comprehensive approach for stream studies and
abatement of pollution from all municipalities and industries. 44

«<. Appendix E. Howard W, Chapman'* tetter.

FLORIDA HEALTH NOTES

51

FUiRlOA STATE LIBRARY

SELECTED BIBLIOGRAPHY

Published books and pamphlets

Annual Report, 1946, Florida State Board of Health, Jacksonville,
Florida.

Annual Report, 1956, Florida State Board of Health, Jacksonville,
Florida.

Annual Report, 1965, Florida State Board of Health, Jacksonville,
Florida.

Clean Water — A Challenge to the Nation, U. S. Department of
Health, Education, and Welfare, Public Health Service, Wash-
ington, D. C. 1960.

Florida's Water Resources. Report to the Governor of Florida and
the 1957 Legislature by the Florida Water Resources Study
Committee, Gainesville, Florida, December 1956.

Living Waters, The. U. S. Department of Health, Education, and
Welfare, Washington, D. CL, 1961.

Kerr Report No. 9. Water Resources Activities in the United
States — Pollution Abatement. Select Committee on National
Water Resources, U. S. Senate. U. S. Government Printing Of-
fice, 1960.

Macan, T. T. and Worthington, E. B. Life in Lakes and Rivers.
Collins of London, 1959.

McNulty, J. Kneeland, Reynolds, Ernest S. and Miller, Sigmund
M. "Ecological Effects of Sewage Pollution in Biscayne Bay,
Florida; Distribution of Coliform Bacteria, Chemical Nutrients

52 • FLORIDA HEALTH NOTES

and Volume of Zooplankton," Biological Publication in Water
Pollution, Transaction of the 1959 Seminar. U. S. Department
of Health, Education, and Welfare, Public Health Service, Rob-
ert A. Taft Sanitary Engineering Center, Cincinnati, Ohio.

Potomac, People, Pollution, The. U. S. Department of Health, Edu-
cation, and Welfare, Public Health Service, Washington, D. C,
1951.

Protecting Our Water Resources. U. S. Department of Health,
Education, and Welfare, Public Health Service, Washington,
D, C, 1962.

Smith, David B. Stream Sanitation in Florida. Florida Engineer-
ing Series No. 1, College of Engineering, University of Florida,
Gainesville, Florida, 1954.

Water Pollution in the United States. U. S. Department of Health,
Education, and Welfare, Public Health Service, Washington,
D. C, 1951.

Woodward, H. B. Washing Our Waters: Your Job and Mine.

Public Affairs pamphlet, No. 193, Public Affairs Committee,
New York, N. Y., 1953.

Magazines and Newspapers

"After Air— Water!" Florida Health Notes, Florida State Board
of Health, Jacksonville, Florida, Vol. 41, No. 1, January 1949.

"Clean Water— Clear Air" Florida Health Notes, Florida State
Board of Health, Jacksonville, Florida, Vol. 48, No. 10, Decem-
ber 1956.

Renn, Charles E. "Water," The Johns Hopkins Magazine, Johns
Hopkins University, Baltimore, Maryland, Vol. 17, No. 8, July
1966.

Spivak, Jonathan, Wall Street Journal (New York), January 19,
1966.

"Stream Pollution," Florida Health Notes, Florida State Board of
Health, Jacksonville, Florida, Vol. 39, No. 10, October 1947.

FLORIDA HEALTH NOTES

53

Unpublished Papers and Reports

Austin, Mark. "The Scarce Engineer," Florida State Board of
Health, Jacksonville, Florida, 1966.

Baker, Ralph H. "Developments and Trends in the Control of Water
Quality," Presented at the Florida Engineering Society Conven-
tion, Orlando, Florida, April 1961.

Biscayne Bay Pollution Survey, May through October 1949. Bureau
of Sanitary Engineering, Florida State Board of Health, Jack-
sonville, Florida.

Lee, David B. Paper presented before the Twenty-first Annual
Meeting of the Soil and Water Conservation Supervisors, Tampa,
Florida, August 18, 1966.

Patton, Vincent D. "Stream Pollution" paper presented before the
Florida Chapter, American Public Works Association, Sixth An-
nual Convention, Tampa, Florida, May 5, 1966.

Progress Report, Lake Worth Survey, July-August 1962, Bureau
of Sanitary Engineering, Florida State Board of Health, Jack-
sonville, Florida.

Report on State Institutions, 1966, Bureau of Sanitary Engineer-
ing, Florida State Board of Health, Jacksonville, Florida.

"The Sewerage Problem" paper presented by Division of Waste
Water and Division of Special Services. Bureau of Sanitary Engi-
neering, Florida State Board of Health at Urban Planning for
Environmental Health Course, Sarasota, Florida, June 20, 1966.

54 • FLORIDA HEALTH NOTES

APPENDIX A

(1) Letter from Ray L. Wilson, At-
torney, Jacksonville, Florida, to
Wilson T. Sowder, M.D., Florida
State Health Officer.

(2) Letter from Wilson T. Sowder,
M.D., Florida State Health Of-
ficer to Ray L. Wilson.

FLORIDA HEALTH NOTES • 55

APPENDIX A (1)

Law Office of Telephone 355-1155

RAY L. WILSON (Area Code 904)

BARNETT NATIONAL BANK BUILDING
JACKSONVILLE, FLORIDA 32202

August 6, 1966

Dr. Wilson T. Sowder
State Health Officer
State Board of Health
Jacksonville, Florida

Dear Dr. Sowder :

I notice in today's press that you plan to make a strong bid
for an appropriation of $5,000,000.00 to aid the Board's efforts in
improving the quality of the State's air and water resources.

I have not investigated, verified, nor validated the common
knowledge around Duval County that the Municipality of Jackson-
ville and others dump several million gallons of raw sewage per
day into the St. Johns River. However, if that is true, and if it is,
the State Board of Health should know it. I don't understand why
you do not take advantage of Section 387.08 of the Florida Statutes
and endeavor to eliminate the portion of water pollution mentioned
here.

I would like to hear from you regarding this matter.

■

Very truly yours,

RAY L. WILSON
56 • FLORIDA HEALTH NOTES

APPENDIX A (2)

FLORIDA STATE BOARD OF HEALTH

Wilson T. Sowder, M.D., M.P.H., State Health Officer

Malcom J. Ford, M.D., M.P.H., Deputy State Health Officer

Jacksonville, 32201

August 15, 1966

Mr. Ray L. Wilson

Attorney at Law

Baraett National Bank Building

Jacksonville, Florida 32202

Dear Mr. Wilson :

Further reference is made to your letter of August 5th about
raw sewage being dumped into the St. Johns River by the City of
Jacksonville and asking why the State Board of Health does not
take advantage of Section 387.08 and endeavor to eliminate the
water pollution involved. I have now had an opportunity to dis-
cuss this matter with Mr. David B. Lee, Director of our Bureau
of Sanitary Engineering; and we both have had an opportunity
to review our files and refresh our minds on this important subject.
I am answering your question in some detail because it is an im-
portant one. Furthermore, the State Board of Health itself has
for several years been responsible for letting all concerned know
that this is the most outstanding example of water pollution in the
whole state.

The Florida State Board of Health has, especially during the
past 20 years, worked very diligently throughout the state to pre-
vent pollution and preserve the water resources for the protection
of the health of the people as well as for the value of these waters
for fishing, recreation, and other purposes ; and has worked primari-
ly through its Bureau of Sanitary Engineering under the able direc-
tion of Mr. David B. Lee. It is well known throughout the country
that the Florida State Board of Health and the staff of the Bureau
of Sanitary Engineering under Mr. Lee's direction have done out-
standing work in this field. Concrete evidence of this is contained
in one of the enclosures indicating Mr. Lee's selection for a Na-
tional Award for his outstanding work in this field. I request
that you not give any publicity to this until the organization in-
volved has made the formal presentation next month.

FLORIDA HEALTH NOTES

57

The fact that the people of the State of Florida are now aware
of the problem of pollution is due primarily to these vigorous
efforts of the Florida State Board of Health during the past 20
years. During- that time and as a result of this effort a total of
1,550 sewage treatment plants have been built and the spread of
water pollution has been halted in spite of rapidly increasing in-
dustrial developments and the rapid growth of the population. It
is, of course, true that we still have many difficult problems ahead
of us which that in Jacksonville is an outstanding example. How-
ever, the larger percentage of the waters of the state, including
the rivers, lakes, and beaches, are not polluted and probably less
than five to 10 per cent of the waters of the state have any gross
pollution. These facts are important, and related to your question
in that they put the Jacksonville problem in proper perspective.

The Florida State Board of Health and the United States Public
Health Service made an extensive pollution survey of the St. Johns
River during the late 40's and a copy of this report was furnished
the City of Jacksonville. The State Board of Health has continued
since then to exert pressure upon the city as well as the rapidly
growing area surrounding Jacksonville, and we know we have
accomplished a great deal. As you know, today we have more
population in the suburban area surrounding Jacksonville than we
do within the corporate limits, and our agency has been successful
in bringing about the construction of some eighty large treatment
plants in the county to prevent further pollution of the St. Johns
River. It has been the firm policy of the State Board of Health
for many years to prevent any further degradation of the rivers
and lakes of the state.

The City of Jacksonville in 1953 retained Dr. Abel Wolman of
Johns Hopkins University, a consulting engineer with a national,
and even an international reputation, in the field of water pollu-
tion. After his survey, he made a report stating that the city did
not need waste treatment for many years in the future.

Doctor Wolman was also retained as the consulting engineer
by the City of Sanford; and, in his report of June 1, 1953, he also
stated that Lake Monroe could assimilate all sewage from the city.
Even working against the handicap of such opinions, we are
happy to say that Sanford now has a fine sewage treatment plant,
and we are hopeful that it will upgrade this to secondary treat-
ment in the near future.

Doctor Wolman has for many years been an outstanding advo-
cate of the cliche that "the solution to pollution is dilution." If

58

FLORIDA HEALTH NOTES

this view of the disposal of raw sewage were valid anywhere in
Florida, it naturally would be here in Jacksonville where we have
the largest volume of moving water available anywhere in the
state.

On September 28, 1955, the consulting engineering firm of Met-
calf & Eddy from Boston, Massachusetts, filed their report and rec-
ommendations for a master plan covering the Jacksonville-Duval
area. This report also stated that "the substantial elimination of the
discharge of untreated sewage from the City of Jacksonville into
the St. Johns River and its tributaries would not be needed until
the fourth stage of the program." They also listed the costs of
the various phases, and the total was $109,600,000, a sizeable sum
of money. About that time the State Board of Health had been
requested by the city to approve the sewering of northwest Jack-
sonville, the unsewered portion of the city, and to pipe this waste
into the river at the Main Street Bridge untreated.

In spite of the opinions from these distinguished sources, the
State Board of Health and its Bureau of Sanitary Engineering has
steadfastly rejected these proposed solutions to the problem. On
November 1, 1955, the State Health Officer notified the city that
we would not approve this plan and that the State Board of Health
would use all legal means to prevent any further degradation of
the river. Thereupon, the city directed its engineers to plan a
sewage treatment plant for the first phase of the master plan;
and, on December 15, 1955, the consulting engineers submitted
their preliminary report which was approved in principle by the
State Health Department.

The city proceeded on this first stage operation and on Decem-
ber 12, 1961, the City of Jacksonville dedicated its first sewage
treatment plant located on Tally rand Avenue. This is a very fine
plant and has received the award of the State Board of Health
several times for good operation. I am attaching a copy of the
dedication brochure for your information.

Since that time, the board has worked with city officials and
he city now has under active development a program, up-dating
he Metcalf & Eddy report to eliminate raw sewage and industrial
'aste flowing into its tributaries as the first project of the first
base. You may have observed in recent newspaper articles that
he Housing & Urban Development Agency has reserved $072,000
a a grant in aid to the city for this program. This will eliminate
iw sewage and other deleterious materials in McCoy Creek. Other

FLORIDA HEALTH NOTES

59

projects in this program are in the planning stages. Phase 3 will
include the St. Johns River trunk sewer and the South Jacksonville
trunk sewer. A rough estimate of the cost of this program is in
the neighborhood of $25-$30 million. We are confident that the
city will continue their implementation of this plan.

With the above information as a background, I shall now try
to answer your specific question. It has not seemed to us here
at the State Board of Health that section 387.08 of the law which
provides for a fine of up to $500 for violations was likely to be
very effective in dealing with Florida's second largest city in
connection with potential expenditures of over $100,000,000.
Also, I have already called your attention to the fact that the
city has had available outstanding expert advice contrary to the
position which the State Board of Health has consistently taken.
We believe that such testimony would have made it somewhat
difficult for the State Board of Health to win a case in court.
And last of all, the State Board of Health has never had an ade-
quate legal staff to develop and follow through the courts on a
strictly law enforcement basis the many cases that could be made.
We are, incidentally, asking the next legislature to provide funds
for substantial increases in our legal staff. We have also been
conscious of the fact that where such large sums of money have
to be spent to solve a problem, these can only be provided by
interested and willing taxpayers. We have believed, therefore,
that our long-term campaign of educating the public as to the need
for the prevention and abatement of water pollution would pro-
vide the best assurances of appropriate remedial measures being
taken.

We appreciate your interest in the environmental problems of
this area of Florida, and we hope we can enlist your support in
our efforts to provide adequate technical resources in the job
needed ahead. This, of course, means adequate manpower, hous-
ing, laboratory facilities and equipment as well as adequate salary
schedules for engineers and scientists.

If I can furnish you with any further information, please let
me know.

Sincerely,

Wilson T. Sowder, M.D.
State Health Officer

60 • FLORIDA HEALTH NOTES

APPENDIX B

Report from Vincent D. Patton, di-
rector of Division of Industrial
Waste, Bureau of Sanitary Engineer-
ing, Florida State Board of Health,

FLORIDA HEALTH NOTES

61

APPENDIX B

September 6, 1966

To: Mr. David B. Lee

From; Vincent D. Patton

Subject: Health Notes — Water Pollution Issue

Reference the attached memorandum from Mr. Schoonover, we are
furnishing a list of spots where corrective action has been taken
as well as needs for additional action.

Duval County

St Johns River

Alton Box Board Company — Has been informed that ad-
ditional waste treatment will be required.

Ribault River

Gold Merit Packing Co. — Installed treatment plant.

Glidden Company — Installed an oil separator and sewers

— working on the next phase.
The other companies (Container Wire and Wootton Fiber)
are still delaying. These have been referred to Dr. Sowder
for possible legal action.

Cedar River

Allied Petro-Products, Inc. — Installed an oil separator.
Seaboard Airline Railroad — Installed two oil separators.
Painters Poultry — -Installed treatment facility.

McCoys Creek

City of Jacksonville and others discharging untreated
waste.

Dade County

Miami International Airport — Force main installed which
connected to the City of Miami system to collect and
transport waste from the airport and industrial area
immediately east of the airport. This removed waste
which could have gone into the ground in the vicinity
of the well field.

62 • FLORIDA HEALTH NOTES

Putnam County

Hudson Pulp and Paper Company — Installed primary
clarifier. Working toward secondary treatment.
Southland Packing Company — Installed new sewers to
pipe their waste to Palatka's sewage treatment plant.

Brevard County

Cape Kennedy — New plating waste treatment plant be-
ing installed.

Santa Rosa County

Navy installation put in treatment for airplane washing
facility. Escambia Chemical Corporation— Reduced the
strength of its waste through in-plant practices so as not
to affect Escambia Bay.

Escambia County

Newport Industries — Installed a treatment plant.

Armstrong Cork Co. — Installed treatment plant. Both

of these companies had polluted Bayou Chico with wood

waste.

St. Regis Paper Company — Installed settling basins and

a lake to remove solids from the waste and provide

some treatment.

Pensacola Navy Base — Working on design for treatment

of their industrial waste.

Chemstrand Corp. — Installed two deep disposal wells

for strong waste. Working to reduce contamination of

cooling water.

Lake County

City of Leesburg is expanding its sewage treatment plant
which will treat waste from Minute Maid's citrus con-
centration operation.

Orange County

Plymouth Citrus and Minute Maid expanded their treat-
ment facilities and stopped polluting the lake which
was nearby

Winter Garden Citrus — This has been referred to Dr.

Sowder for prosecution.

Many treatment plants have been installed for small plants such

is laundries, meat packing plants, etc. Several large plants have

>een installed to treat the wastes which would otherwise cause

ollution. This would include industrial giants such as Martin Com-

'any, Orlando; Borden Company, Bradenton; Occidental, Hamilton

ounty; Pratt & Whitney, West Palm Beach.

FLORIDA HEALTH NOTES

63

m»

J

h

Clean water has many uses, including such esthetic pleasures as provided
by Jacksonville's Friendship Fountain.

64

FLORIDA HEALTH NOTES

APPENDIX C

Reports from regional sanitary engineers

(1) Report from Nick Mastro, North-
east Florida Regional Office

(2) Report from G. W. Folke, Cen-
tral Florida Regional Office

(3) Report from E. M. Larsen,
Southwest Florida Regional Of-
fice

(4) Report from Richard Starr,
Southeast Florida Regional Of-
fice.

(5) Report from K. K. Huffstutler,
director of Polk-Hillsborough
Air Pollution Control Distirct,
Winter Haven

FLORIDA HEALTH NOTES

65

APPENDIX C - 1

August 30, 1966

TO: David B.Lee

FROM : Nick Mastro

SUBJECT: Forthcoming Issue of Health Notes

In reviewing the activities of this office over the past 20 years
in regard to "Stream Pollution," there are several factors to con-
sider, this being the great influx of people to the State of Florida
and along with this, the increase of industrial plants.

My personal reaction to this question is that overall we have
done a tremendous task of controlling the pollution of our streams
under adverse conditions. These conditions are being understaffed
and somewhat without any legal or political support from those
in position to assist us.

In my opinion, the stream pollution is not more acute now
than it was 20 years ago. It's true that there are streams that
were polluted 20 years ago and are polluted today. Most of these,
such as the St. Johns River, will within the next few years im-
prove considerably, partly because of our unrelenting program
of surveillance and of constantly pressuring the parties concerned
into providing the necessary treatment facilities.

Today we have approximately 120 sewage treatment plants
serving subdivisions and cities in this region. Twenty years ago
there was no adequate sewage treatment plant in existence in this
region.

Insofar as treating waste from our industrial plants, it must
be admitted that in this area we have not progressed as well as
in providing domestic waste facilities. There are several reasons
for this; first, industries in the past have moved into this area

66 • FLORIDA HEALTH NOTES

and started production without our knowledge; others have come
in and tied onto exisiting sewer lines that discharged untreated
waste to our streams; and then too, others have come in and pro-
vided some treatment devices which were operated for awhile and
then bypassed when found inadequate due to plant expansion or
when the cost of operation and expansion of facilities were found
to be, in their opinion, unwarranted.

The fact that stream pollution has been brought to the public's
attention through news media, the Federal Government's action,
etc., would make the average citizen more cognizant and aware of
pollution today. This, of course, is what we've been trying to do
since as long as I can remember. Now that it's the topic of con-
versation, we have been criticized for what we haven't done. What
we have done with what manpower and assistance that has been
made available to us, the average citizen and news media are un-
informed about. I don't know that we should have to defend our
position, but I do feel all the facts should be made known and
let the public think for themselves.

I definitely do not think we have gone backwards. At the same
time, with adequate implementation of our programs, we cer-
tainly could have moved faster and corrected many problems that
face us today that have been around for quite some time. None
of this is news to you, but, nevertheless, it does summarize what
has transpired in this field as far as I am concerned.

With the emphasis that the Federal Government has placed on
stream pollution, I think that the state legislature, the local gov-
ernments and even our own State Board of Health will be inclined
to support us even more than they have in the past. We know
what the problems are and in the majority of cases know the cure.
We do need to be recognized and given whatever the assistance
needed to expedite and correct these problems and any that might
arise in the future.

FLORIDA HEALTH NOTES

67

MEMORANDUM

APPENDIX C-2

August 29, 1966

TO:
FROM:

Mr. David B. Lee

G. W. Folke

SUBJECT;

Forthcoming Issue of Health Notes,
Entitled "Water Pollution"

We are in receipt of a copy of your memorandum under date
of August 24, 1966, with regard to the subject and we would
offer the following comments:

Speaking for the Central Florida Region, the writer feels that
definite progress has been made in the field of water pollution
control over the last ten to twelve years and particularly in the
last five years, and especially in the field of sewage treatment. At
the present time I know of only two municipalities in the eleven
counties of the Region which discharge inadequately treated sewage
to surface waters. One of these is the Town of Crystal River and,
as you know, we have approved plans for secondary treatment for
this community and financing is the only hurdle to be overcome in
order that construction may start. The other is the Town of
Cedar Key and this community is also working toward adequate
treatment facilities.

1 am not too familiar with the exact dates that older treatment
plants were constructed but I would imagine that in 1947 there
were possibly only two treatment facilities outside of septic tanks
in operation in this Region. One of them would be the existing
Imhoff tank at Crystal River and possibly the other would be the
original intermediate plant at Daytona Beach.

The writer has been in this Region since August 1, 1958, and
since that time the following municipal facilities have been con-
structed or expanded. I am sure that many of the facilities con-

68

FLORIDA HEALTH NOTES

strutted in the last eight years got their impetus from Mr. Ber-
kowitz and personnel from the Jacksonville office:

Orange County

1. Southwest Orange County sewage treatment plant modified
to treat additional flows.

2. Northwest Orange County plant {Pine Hills) enlarged,

3. The City of Maitland sewage collection system and treat-
ment plant constructed.

4. I do not have the necessary records in this office but I
believe the City of Apopka and City of Winter Garden treatment
plants were expanded.

5. City of Winter Park sewage treatment plant is presently
being expanded.

6. City of Orlando No. 2 sewage treatment plant constructed.

Seminole County

1. City of Sanford Plant constructed.

Osceola County

1. City of St. Cloud provided additional capacity and secondary
treatment, whereas the original plant provided primary treatment
only.

2. City of Kissimmee. Plant expansion presently under con-
struction.

Volusia County

1. City of Ormond Beach constructed sewage collection and
treatment facilities.

2. City of Holly Hill constructed sewage collection and treat-
ment facilities.

3. City of Daytona Beach constructed first phase of new
sewage treatment plant to provide secondary treatment instead
of primary treatment as previously constructed. Plans have been
approved for the second phase of construction to double capacity
of this plant.

4. City of Port Orange constructed sewage collection system
and treatment plant.

5. City of New Smyrna Beach constructed sewage collection
system and treatment plant.

6. City of Edgewater constructed sewage collection system and
reatment plant.

7. City of Deland constructed plant expansion to provide sec-
ondary treatment whereas primary treatment was previously prac-
iced.

FLORIDA HEALTH NOTES

69

Lake County

1. City of Mt. Dora constructed sewage collection and treat-
ment plant.

2. City of Eustis constructed plant expansion which doubled
capacity of their secondary treatment plant.

3. City of Leesburg plant presently under construction to pro-
vide secondary treatment whereas primary treatment is presently
practiced. This new plant will also treat waste waters from the
Minute Maid citrus processing plant.

4. City of Umatilla sewage treatment plant recently completed,

Marion County

1. City of Belleview sewage collection and treatment facilities
constructed.

2. City of Dunnellon sewage collection and treatment facilities
constructed.

3. City of Ocala planning is presently underway for sewage
collection and treatment for a large area recently annexed to the
City.

Sumter County

1. City of Wildwood sewage treatment plant and additional
sewers constructed.

Pasco County

1. City of New Port Richey sewage collection and treatment
facilities constructed.

2. City of Zephyrhills. Final construction plans for sewage
collection and treatment are presently being prepared as result
of a successful referendum for the project.

Hernando County

1. City of Brook sville sewage treatment plant constructed.
Plans are presently being prepared for expansion of the sewage
treatment plant and plans for some sewer extensions have been
approved.

Citrus County

1. City of Inverness. Sewage collection and treatment facil-
ities constructed.

2. Town of Crystal River. Plans have been approved for a
sewage treatment plant to provide secondary treatment and fi-
nancing is presently being worked out.

70 • FLORIDA HEALTH NOTES

Levy County

1. City of Williston had a sewage treatment plant prior to the
writer's entry into the Central Florida Region.

Several municipalities, which are presently served by individual
septic tank installations, have had and are in the process of having 1
prepared engineering reports relative to sewerage. Undoubtedly
within the next few years sewage collection and treatment fa-
cilities will be forthcoming in many of these communities.

In the opinion of the writer, our greatest gray area relative
to sewage collection and treatment is in areas outside of munici-
palities where County Commissions and County Health Depart-
ments have permitted heavy concentrations of population to be
served by individual septic tank, and tile drainfield installations.
Our only salvation in these areas is that they be annexed to
municipalities where sewerage can be provided or county sewer dis-
tricts must be formed to provide the necessary service. This prob-
lem gets back to our old "preaching mission" that we must have
good sound planning and zoning in these areas.

In addition to the municipal sewage treatment plants, we have
had several hundred sewage treatment plants installed to serve
subdivisions, hotels, motels, shopping centers, trailer parks, camps
and camp grounds, and other types of individual installations. The
majority of these installations have been made within the past
ten years.

With regard to industrial wastes, I believe that we have made
good progress in securing adequate treatment in new develop-
ments. Here, one of our gray areas appears to be in the citrus
processing industry. From what I have seen in this Region, most
of the industry is content to dump their wastes without treatment.

Another definite threat that I see to our surface waters, espe-
cially in areas where there is considerable swampland adjacent
to the open waters, is the installation of muck farm operations.
This is an item that is going to have to be resolved by the State
Board of Health and agricultural interests.

I realize this is not in capsule form as requested, but it is felt
hat the foregoing information is pertinent. If you desire any
-irther information or opinions, kindly advise.

FLORIDA HEALTH NOTES

71

APPENDIX C-3

August 31, 1966

TO:

Mr. David B. Lee

FROM:

E. M. Larsen

SUBJECT: General Strm. Pol.

Forthcoming Issue of Health Notes,
Entitled "Water Pollution"

This memorandum and attachments are to conform to your
request in a memorandum dated August 24, 1966 bearing the above
subject matter.

THE PAST — Please refer to Chart No. 1, attached, which in-
dicates planned expenditure on plans approved by our agency
covering sewerage and industrial waste projects from 1951-1965.
At the time of my employment in July, 1951 there existed only
three sewage plants in the southwest region. One of these was
the City of Sarasota plant, which was completed in early 1951.
The other two plants were those located at the G. Pierce Wood
Memorial Hospitals located in Arcadia. These were built apparent-
ly by the army during World War I or n.

The sewage program in southwest Florida really got under
way during 1955 when more than two million dollars was spent.
Since 1955 through 1965, dollar volume has varied considerably.
The average spent, based on a fifteen year average, was over 1.9
million; the average for the last ten years has been over 2.6
million; and the average the last five years has been over 2.3
million dollars. The number of sewage projects has averaged 35.8
the last fifteen years and has reached an average of 65.8 projects
in the last five years.

The industrial waste program is also expanding and develop-
ing in this area. Please refer to chart for details.

PRESENT CONDITIONS— Please refer to chart No. 2 indicat-
ing the number of sewage plants and type. Since 1950 this area

72

FLORIDA HEALTH NOTES

has gone from two sewage plants to 140 as of this date. We are
now in the throes of needing plant expansions at some of these
plants. The trickling filter plants that are overloaded are: The
City of Sarasota, Kensington Park Subdivision in Sarasota County,
and the Punta Gorda Plant in Charlotte County. Sarasota has
hired an engineer to develop plans for expansion, Kensington Park
has had plans approved for expansion but has refused so far to
commence with the construction, and Punta Gorda has not so far
done a thing.

The air plants that are overloaded are Naples, which has a
construction expansion program under way; and the South Gate
Plant in Sarasota County has expansion plans approved, but con-
struction has not commenced.

At the present time we have only two municipalities that are
dumping raw, untreated waste into our streams. They are: La
Belle, which has had plans approved, and construction should com-
mence sometime during late 1966 or early 1967; and the City of
Everglades, with plans approved, but the City Commission has
passed a resolution indicating that they will not build the plant.
We are experiencing also some sewage problems from septic tank
failures in various areas of my Region, and one of these is the
Charlotte Harbor area, and the other is the Englewood area.
These areas are organized into the Englewood Sanitary District
and the Charlotte Harbor Association. These organizations are
in the water supply business at the present time, which should
assist us in getting sewers and sewage treatment in these sections
in the future. In the Russell Park area east of Ft. Myers we
have some dumping of sewage in the Caloosahatchee River, and
I do strongly believe that we have a pollution problem through
storm drains from the City of Moore Haven, but have no documen-
tary evidence.

In the field of industrial waste we have several problems. One
of these problems is the discharge of waste from the Gulf Naval
Stores, Nocatee, Florida, into Peace River; the other industrial
waste problem we have is in the Hendry and Glades counties re-
garding sugar waste, and citrus waste discharge at Arcadia. (Brad-
enton also has a citrus waste discharge.)

POSSIBLE FUTURE CONDITION- It is felt that our sewage
urogram will proceed year by year at the rate of at least two
nillion dollars per year, and our Industrial Waste program should
ontinue at the rate of approximately $75,000 per year. This

FLORIDA HEALTH NOTES

73

area I do believe needs legal assistance, and very likely legal action
to solve some of its problems in the field of stream pollution and
potable drinking water, The communities involved are the City
of Everglades and Moore Haven. We have tried using education,
discussion, persuasion, conciliation, etc., but these two communities
hold an open defiance to the State Board of Health, and possibly
any other controls outside their communities. You, Mr. Baker
and Mr. Miller are independently, or collectively, familiar with
these two problems. The matter of sewage treatment processes
being built for motels, trailer parks, hotels, etc., does not constitute
a problem at all due to the Sanitary Code requirements. Develop-
ing subdivision developments with septic tanks, will continue to
be a problem and will effect the future in this field unless we take
definite steps, refortifying our controls over the installation of
septic tanks in subdivisions. In areas where we have open defiance,
like the City of Everglades, we will run into trouble unless we take
legal action to get compliance. During my early years in the region
we were happy to obtain almost any degree of treatment of our
sanitary waste, such as primary treatment only. Today our thoughts
have changed in that we are now expecting at least 95-98% re-
moval, but will accept nothing less than 80-85%. Even with the
80-85% it is doubtful whether it would be approved without ponds,
which give us a better degree of treatment. As can be seen from
Table 2, more than 77% of the sewage plants in this area have
a degree of treatment of 93-99%.

Recent additional personnel will assist greatly in the field of
operation and expansion programs. It is felt that the present staff
is still inadequate when you realize that we have 140 sewage plants,
many laundry plants, a large number of water treatment facilities
and an expanding number of incinerators. Mr. Vincent Pat ton has
written a large number of letters to the laundry plants in this area
indicating inadequate treatment and/or operation of the laundry
treatment facilities. This problem will become much more severe
unless we tighten up to a point where we do not permit laundry
plants to be installed unless they are connected to a sanitary sewer.

SUMMARY — -It is my feeling that we have made a great deal
of progress in this area as can be seen by the fact that over 28.7
million dollars has been spent on sewage facilities in this area and
over $560,000 on industrial waste treatment since 1951. However,
I do feel that we are keeping ahead in the field of sewage where
we take care of the transit business such as motels, trailer parks,
apartments, etc. ; but it is my feeling that we are slipping behind
where our permanent population is developing. We have a tre-
mendous amount of septic tanks being installed in subdivisions
that should not be granted by the County Health Departments. In

74 • FLORIDA HEALTH NOTES

the field of industrial waste I feel that we are moving forward.
It is felt that this is due to several reasons, and they are:

(1) Much fewer installations involved.

(2) No substitutes available in treatment of industrial waste,
such as several septic tanks for sewage treatment plants.

(3) The County Health Departments have no jurisdiction in
this field as they do with septic tanks in the field of sewage treat-
ment.

(4) The promotion of the air and water pollution programs by
the State Board of Health and the Federal Government.

(5) Public opinion is concerned about pollution, water and air,
caused by industry. It is felt we get better support from the
public in this field.

I realize that this is a rather long memorandum, however it
was felt it was better to give you all the data available, from which
you could sift and screen the data you would like to use in the
forthcoming issue of Health Notes, "Water Pollution."

FLORIDA HEALTH NOTES

75

-4
Ok

Chart No. 1

SOUTHWEST REGION — 8 COUNTIES

•

1951

Population

No of MS
Projecti

L

1 No. of MS
Pfoicctt

Act- Totoli

MS Projotti
Coif— $

MS Project.

Cojt— 5
Ace. Totoli

No. of IW

PmjMtl

No. of IW (W Pro].
Protect* Cott — $
Ace. Totoli

IW Proj.
Ace Totolt

No. of

Operating
MS PlonN

O

2

94,630

3

D

11)52

97,810

1

1

26,000

26,000

►

19S3

101,030

1

26,000

X
rn

1954

109,836

5

6

70,601

96,601

1

1

2,000

2,000

►

1955

114,653

6

12

2,114,748

2,211,349

2

3

5,000

7,000

g

1956

130,000

9

21

1,703,514

3,914,863

4

7

11,000

18,000

17

X

1957

143,000

20

41

862,708

4,777,571

3

10

11,000

29,000

z
o

H

1958

156,400

44

85

3,876,320

8,653,891

1

11

4,600

33,600

20

1959

167,400

56

141

4,567,363

13,221,254

6

17

19,300

52,900

5

1960

187,500

67

208

3,918,581

17,139,835

4

21

93,500

146,400

1961

218,800

79

287

2,154,570

19,294,405

5

26

26,000

172,400

1962

223,600

60

314

1,625,126

20,919,531

7

33

34,000

206,400

1963

239,400

58

405

3,374,671

24,294,202

12

45

198,900

405,300

1964

234,200

59

464

1,850,937

26,145,139

6

51

139,864

545,164

132*

1965

243,700

73

537

2,640,693

28,785,832

3

54

15,000

560,164

Ave/ year last 15

years

35.8

1,919,056

3.6

37,344

Ave /year last 10

years

52.5

2,657,449

5.1

55,316

Ave/year last 6

years

65.8

2,329,200

6.6

82,753

ul October 1

, 1964

Chart No. 2

SEWAGE TREATMENT PLANTS

Imhoffs and ponds -»

Imhoff with secondary, and maybe ponds

Primary, trickling filter & secondary

Primary, trickling filter & secondary (overloaded)

Extended air, contact, activated sludge
and maybe ponds

Extended, air, contact, activated sludge,

and maybe ponds (under construction)

Air plants (overloaded)

Combination air plant with primary, trickling
filter, secondary and pond

TOTAL

6
13
11

3

99

5
2

140

MUNICIPALITIES WITHOUT TREATMENT

(Raw sewage being dumped)

La Belle — Plans approved. Construction will start sometime during
late 1966 or early 1967.

Everglades — Plans approved. City Council informed us they will
not build.

Russell Park, near Ft. Myers — No plans to change this problem
by S/D.

Englewood — No plans being made yet by CHD, and this office has
appeared at public meeting.

Charlotte Harbor, near Punta Gorda — No plans by area being
considered,

Moore Haven — Possible septic tank discharge thru storm drains
and etc., into Caloosahatchee River.

INDUSTRIAL WASTE DISCHARGE

(No treatment and more needed)

fus Plant at Arcadia

f Naval Stores at Nocatee

ar Mill waste in Hendry and Glades Counties

FLORIDA HEALTH NOTES

77

APPENDIX C-4

Date : August 29, 1966
To: Mr. D. B. Lee

From: Dick Starr

Subject: Forthcoming Issue of Health Notes, Water Pollution

In reply to your memo of August 24, I would like to break
my region down into three categories to answer your question
about pollution control. These categories would be the Keys, the
Indian River Counties and the interior counties.

I would say that we have made progress in the Keys. This is
mainly due to the fact that methods of waste disposal in that area
have been so primitive that almost anything would be an improve-
ment. To the best of my knowledge there are no more tidalflush
cesspools being installed. In most cases these have been supplanted
by septic tanks with a modified sand filter drainfield. This system
has not been as successful as it should be due to the bootlegging
of local unsatisfactory calcite material as sand. In the larger
installations we are meeting with considerable success in providing
package treatment plants and in many cases reclaiming the effluent
from these plants for irrigation purposes. Several subdivisions
have also provided sewers and treatment and there is evidence that
the Naval installations will eventually provide effective treatment
for their wastes. Industrial waste is not a significant problem
in this area with the exception of laundry waste. There are still
zones of pollution along the shorelines but they need to be better
defined before the source can be determined.

The three counties along the Indian River are at best just hold-
ing their own in the overall picture. We have made notable progress
in treating the municipal waste that used to go in the Indian
River raw and have removed a number of tail pipe dicharges so
that we show a net gain on the river. However nothing has been
accomplished on the sewage from boats and from the bridge tender
houses at the draw bridges. We continue to lose ground in the
pollution generated by the continuing proliferation of septic tanks,

78 • FLORIDA HEALTH NOTES

1 1

The potential pollution from discharge from agricultural lands
ncreases constantly and there have been some problems with citrus
j)i*ocessing waste that could increase as more groves come into pro-
duction. There is also the new problem of sedimentation in the
saline estuaries from expanded drainage works.

Okeechobee County is definitely a problem area and appears
to be getting worse. While we have a sewage treatment plant for
the City of Okeechobee the discharge of canning waste to this
plant knocks it out for several months at a time with resulting
gross pollution of Taylor Creek. If this problem can be solved
and we get tertiary treatment of all sewage, the domestic waste
situation will be satisfactory. However the enormous growth of
the dairy industry in this county has created a problem of manure
disposal which is going to be very serious if a solution for propter
disposal is not worked out. Since this county is primarily agricul-
tural there is not a serious problem at the moment from septic
tanks but the areas near the lake will become critical in the future.

Highlands County has shown progress in municipal waste treat-
ment but there is room for improvement and there are far too
many septic tanks being installed. Industrial waste is not a prob-
lem at present and the agricultural operations do not appear to
be harming the lakes in this area. I would say we were holding
our own except for the septic tanks.

In viewing the overall picture I am forced to conclude that we
are losing ground in combating pollution and will continue to do so
as long as the concept that growth of any type is progress and
until the agricultural interests are made to realize that they must
conduct their operations so as to prevent pollution.

FLORIDA HEALTH NOTES

79

APPENDIX C-5

September 2, 1966

TO:

Mr. D. B. Lee

FROM:

K. K. Huffstutler

SUBJECT: Stream Pollution, General

With regard to your memo of August 24th concerning informa-
tion on water quality control for "Health Notes," we assume that
our opinions are desired, since we received a copy of the memo.
The following is a composite of the thinking of our people involved
in water quality.

We do not feel that the State Board of Health is actually going
"backward," however, we are not keeping pace with the growth
of the state even when ignoring the unbalanced ratio of state
population to ageney resources.

Speaking strictly from an industrial waste and water quality
standpoint (no domestic waste considered), some of the glaring
shortcomings in the water quality program that could possibly
be corrected without significant additions to personnel and other
resources involve the modernizing of:

1. The education and knowledge of existing personnel

2. Methods of sampling and analyzing

3. Equipment — both field and laboratory

4. Yardsticks for measuring quality

5. Interpretation, storage and use of data

There is a strong need for improving public relations, in order
to reveal the accomplishments brought about despite the short-
ages of resources. Better public relations would establish a uni-
form definition or interpretation of "pollution." There is a neel
for some sort of lobby to aid in the correction and improvement

80

FLORIDA HEALTH NOTES

of existing laws. The entire program would be improved by better
communications within the bureau. A case in point is informing
the field personnel as to what each other is doing, and the resulting
accomplishments. Industry should be made aware of the fact that
we must have additional publicity; consequently, their particular
company may be included in various news releases, good and bad,
but with their knowledge.

We suggest that the bureau acquire an "eagerness" to refer
possible cases to Dr. Sowder and Mr. Andersen, regardless of how
flimsy the basis for such legal action may be. Such "eagerness"
will greatly reduce the administrative delays, and in most cases,
indicate to the public and press that something has been done
before the news media set up their crusading campaigns against
the State Board of Health. We know of no case where criticism
of the State Board of Health has been forthcoming due to the lack
of success when something has been attempted. All criticisms
have been because the State Board of Health has failed to try
for correction or improvement.

We leave any comments pertaining to domestic waste problems
and nutrification resulting therefrom to the people closely asso-
ciated with these problems. Of course, we are involved with the
nutrification problems, but the stimulation of research toward the
correction should come from the people in Baker's discipline.

FLORIDA HEALTH NOTES

81

Yachts and ships are polluters when they allow sewage or oil to spill int<
Florida's waters.

82

FLORIDA HEALTH NOTES

APPENDIX D

I
1 1

Reports from county sanitary engineers

(1) Report from Robert L, Quick, director, Engi-
neering Division, Dade County Department of
Public Health

(2) Report from George T. Lohmeyer, director
Sanitary Engineering, Broward County
Health Department

(3) a. Report from Frank L. Cross, Jr., sanitary

engineer, Manatee County Health Depart-
ment

Supplemental Reports from Manatee County

(3) b. Report from Allen Kretschmar, di-
rector of Sanitation Division, Manatee
County Health Department

(3) c. Report from George Dame, M.D., di-
rector, Manatee County Health De-
partment

(4) Report from Donald W. Roberts, director,
Sanitary Engineering, Hillsborough County
Health Department

(5) Report from Harold Leadbetter, sanitary
engineer, Pinellas County Health Depart-
ment

(6) Report from Lawrence D. Lukin, director,
Environmental Health, Palm Beach County
Health Department

FLORIDA HEALTH NOTES •

83

APPENDIX D - 1

TO: D. B. Lee, Director

Bureau of Sanitary Engineering
Florida State Board of Health

FROM: Robert L. Quick, Director
Engineering Division
Dade County Department of Public Health

Water pollution is a subject that has received a great deal of
publicity over the past several months with news releases relative
to the Federal water pollution control program and state and local
problems. The question of "What is pollution?" is an interesting

one.

Water pollution manifests itself through changes in water
quality, ranging from gross to subtle. Various authorities have
offered, either directly or by implication, definitions of water pol-
lution with the words "contamination," "nuisance" and "degrada-
tion" frequently encountered. The words contamination, nuis-
ance and degradation are useful words but we have enough
trouble defining "pollution." However, when a body of water is
suffering from pollution, it is certainly degraded, probably
contaminated and possibly creating a nuisance. One thing the
definitions have in common is they all refer to the impairment
of water quality and to the resultant adverse effect on water uses.

The Dade County Health Department and Florida State Board
of Health have worked very diligently over the past 16 years to
prevent pollution and preserve the water resources for the pro-
tection of the health of the people. In 1950, there were only two
or three small sewage treatment plants serving isolated areas with
portions of the City of Miami sewered but discharging this waste
water into Biscay ne Bay and the rivers through seventy (70) sewer
outfalls. It wasn't until 1954, after repeated surveys and warnings
from the Health Department, that the citizens voted and approved
a bond issue that would remove these sources of pollution. Also,
since 1954, there have been some 75 sewage treatment plants con-
structed with sewage collection lines serving the adjoining areas.
It is estimated that a permanent population of approximately
564,000 are served by public sewerage systems which represent ^
about 46 percent of the population of Dade County.

84 • FLORIDA HEALTH NOTES

The fact that the people of Dade County em now aware of the
problem of pollution is due to efforts of the Health Department
over many years and the recent action at the Federal level. As a
result of these efforts, several municipalities and the county have
applied for and received Federal grants to install sewerage collec-
tion systems and transmission mains that will be of great benefit in
removing pollution in the areas served. It is. of course, true that
we still have many difficult problems ahead before a unified sani-
tary sewerage and disposal system can be constructed to serve
the Metropolitan Dade County area as the estimated cost of the
first phase of the project envisioned to be completed before 1970
approximates $100 million dollars. Thus, our day-to-day problem
will be to halt the spread of water pollution in spite of the rapidly
increasing industrial developments and population growth.

FLORIDA HEALTH NOTES

85

APPENDIX D - 2

September 11, 1966

David B. Lee, Director
Bureau of Sanitary Engineering
Florida State Board of Health
Jacksonville 1, Florida

Dear Mr. Lee:

This is written in reference to your recent memorandum called
"Forthcoming Issue of Health Notes entitled 'Water Pollution."'
In this memo you requested an opinion from this department re-
garding the past, present and future situation on water pollution.

PAST — The writer has been with the Broward County Health
Department since 1961. We feel that we may be in a better posi-
tion than others to make evaluations on this topic inasmuch as we
came into this regulatory field only a short time ago. While there
is much to be done on water pollution control in the county we
already feel, to paraphase Winston Churchill, never was so much
owed by so many to so few members of the Florida State Board
of Health for combatting water pollution to the degree that has
been obtained. In 1947 the population of Broward County stood
at approximately 69,000 ; today, approximately 20 years later, our
population exceeds 500,000 people. With this tremendous in-
crease in population it is completely understandable that with
our few staff members we do have potential problems on water
pollution. By and large our main pollution threat comes from some
85,000 septic tanks in our county. Because of this, it is a matter
of record that the eoliform count in our tidal canals is higher than
desired.

PRESENT — Today, the Engineering Section of the Broward
County Health Department consists of seven individuals responsi-
ble for 1006 approved public swimming pools, 40 approved public
water systems and some 65 approved public waste water systems.
With this meager staff this department also maintains 20 air pol-
lution dustfall stations in the county, maintains surveillance of
the bacteria quality of our public bathing beaches and tidal canals
and maintains a responsible surveillance of all sources of in-
dustrial waste and pollution including four municipal -type incin-
erators. Our staff members work with our public swimming pool
operators, water and waste water plant operators, assisting in train

86 • FLORIDA HEALTH NOTES

ng lectures throughout the year. Also to be mentioned is the re-
view of plans on public water supplies, public waste water systems,
industrial waste, public swimming pools and septic tanks. Our
^taff members and our County Health Officer have worked and
are working diligently among the governmental leaders of the
county in encouraging the leadership to provide consolidated waste
water and public water supply systems. It is a matter of record
that Broward County is one of the few larger counties in the State
of Florida which presently has sufficient incinerator capacity to
handle all putrescible, municipal garbage.

In spite of the need for additional staff members, this depart-
ment looks at the future with optimism and confidence. In com-
batting our major problem, the septic tank, enormous strides are
underway which in five to ten years should startle pollution con-
trol experts. We point out the City of Ft. Lauderdale is moving
into a master sanitary sewer program which will provide sanitary
sewers for all of the 125,000 people in the city just as soon as the
engineering and monies are available. The City of Hollywood is
planning to construct a 10,000 ft. ocean outfall which will not only
accommodate the present 87,000 people in Hollywood but also the
present 18,000 people in the City of Hallandale, The City of
Pompano Beach already possesses an ocean outfall which will ac-
commodate not only the 27,000 people in Pompano but also all of
the citizens who will live in the Pompano Beach Greater Reserve
Area. Also, Broward County has moved into a county utility sys-
tem aimed at consolidating water and sewer facilities for the
citizens in our unincorporated areas.

It cannot be denied that in spite of the challenges listed above,
Broward County is presently in an enviable position insofar as air
and water pollution is concerned when the tragic situations in other
parts of the country are viewed. It is the firm conviction of this
department that the citizens of Broward County want to maintain
and improve upon these environmental conditions with the sup-
port of the officials elected by the people in Broward County which
we have received and which we feel certain can be expected in the
future. Environmental health conditions in this area will improve
as each year goes by.

Sincerely yours,

George T. Lohmeyer, P.E.
Director of Sanitary Engineering
Broward County Health Department

FLORIDA HEALTH NOTES

87

APPENDIX D-3a

August 31, 1966

Manatee County Stream Pollution
"Health Notes"

Mr. David B. Lee

Florida State Board of Health

Bureau of Sanitary Engineering

P. 0. Box 210

Jacksonville, Florida

Dear Mr. Lee:

Reference is made to your memorandum dated August 24th,
1966 concerning the forthcoming issue of "Health Notes" entitled
"Water Pollution."

As you know, past records of stream pollution would be hard
for me to render, having been in Manatee County only since No-
vember of 1965. Prior to that time, Mr. Larsen headed up the
sanitary engineering activities in this area on a regional basis. I
would certainly be glad to comment on the present conditions of
stream pollution activities in this county.

To start with, we have more than 70 sewage treatment plants,
mostly package in nature, which have been badly neglected. Thus
far we have inspected 10 of these units and have found all of them
sadly lacking in maintenance and upkeep. We are also having
difficulty obtaining operating reports from most of these facilities.
We are in hopes that we can change this situation over a period
of time and bring these plants into proper operation. The larger
plants in this area, namely Bradenton and Palmetto, are generally
working satisfactorily. In fact you will recall that the Palmetto
plant received an award this year for its good operation.

Our activities at the present time include a new pollution con-
trol program in the county. A two story addition is being made
at the Health Department; the downstairs section comprised of
some 2000 square feet of floor space will be for administrative
offices and the entire second floor, containing some 1900 square
feet, will be a new pollution control laboratory. The staff for this
Division presently consists of myself, Sanitary Engineer IV, a
Stenographer II, an Engineering Aide I, and Engineering Aide II,
a Chemist III, and a Laboratory Technician II.

88

FLORIDA HEALTH NOTES

With this new laboratory facility we should be able to do a
considerable amount of stream pollution work along with the other
projects involved in this area. We are currently working on the
shellfish program, which would be directly related to stream pol-
lution, and are trying to open up the Terra Ceia Bay area, both by
shoreline survey and by bacteriological analysis. We are also
routinely sampling Sarasota Bay.

We are also monitoring Ward Lake and the Braden Biver bi-
weekly as a part of our stream pollution activities.

We have already established a pollution network for the county,
consisting of some 12 stations, that will be monitored monthly
after our laboratory goes into operation.

We are working very closely, at the present time, with the
State Laboratory in connection with some fish kills that we have
had of recent origin.

We have run two series of pesticides tests at low and high
water flow, on the tributaries emptying into the new Manatee
County water impoundment. Samples have been collected and
analyzed from wells in the vicinity of the new Borden Complex,
to determine the effect of Borden's gyp ponds on the underground
water supply.

Samples have also been collected for background information
from Bishop's Harbor to determine any possible effect of the dis-
charge from the Borden Complex. Biological indicator jars are
being collected and analyzed monthly in three locations in and
around Piney Point.

We are enclosing a recent newspaper article and if you would
like to use any of these pictures in the issue of "Health Notes," I
am sure we can get the cooperation of the local papers to release

these to you.

In regard to the future, I am sure that with the new facility
and staff at our disposal that we will be able to monitor and control
most of the future and existing problems in this area, given enough
time to get functional.

If you need any more information or any more detailed informa-
tion, please let me know.

Very truly yours,

Frank L. Cross, Jr.

Sanitary Engineer

Manatee County Health Department

FLORIDA HEALTH NOTES

89

APPENDIX D - 3b
Supplemental Report

September 2, 1966 Manatee County

The 1946 population of Manatee County was approximately
25,000. Major population centers, then as now, were the city
of Bradenton with an estimated 10.000 and the city of Palmetto,
estimated at 3300. There was only one sewage treatment fa-
cility in the county, a military installation constructed dur-
ing World War II at the airport with a capacity of 15,600 gallons
per day, however another military installation on Palma Sola Bay
was never completed. There were three municipal sanitary sewer
systems, all discharging untreated wastes into the Manatee River
or Wares Creek. These served from one-half to two-thirds of the
population of Palmetto and Bradenton, respectively, with the third
at Ellenton. The Ellenton system was installed during Florida
boom days when it was a municipality and went into a trusteeship
after disincorporation in the thirties.

The first pollution survey recorded was of the Manatee River,
conducted from September 1947 through January 1948, and the
results published on August 24, 1948. Gross pollution was evident
from the raw sewage discharge. This began an educational pro-
gram which has been continuously carried on in an effort to abate
all water pollution in the county. On July 30, 1948 the Bradenton
city council passed a resolution to begin a master sewerage project
including central treatment facilities. The first phase was approv-
ed by the Florida State Board of Health, September 9, 1948 on
condition that the sewage treatment plant would be constructed
within five years. This first phase resulted in removal of raw
sewage from Wares Creek. Further pollution surveys of the Mana-
tee River were conducted November 1951 through February 1952
and in 1953 from October through November, As a result, the
city of Bradenton, on December 8, 1953, held a referendum for the
purpose of providing sewage treatment facilities and sewer ex-
tensions to serve the entire area within its corporate limits. The
sewage treatment plant resulting was placed in operation in the
fall of 1955 (dedicated October 23), however prior to that date an
additional pollution survey was made of the Manatee River to de-
termine its condition as Bradenton had by then grown to approxi-
mately 14,000 persons. In the spring of 1956 a follow-up survey
was made to determine the improvement after plant operation.
This resulted in opening the south side of the river for recreational
purposes. This survey also pointed up the need for the city of
Palmetto to proceed towards removal of its pollution contribution
of the river, and from that date assistance was directed towards

90 • FLORIDA HEALTH NOTES

I 11

the need of sewage treatment facilities with adequate sewers for
the city of Palmetto, having its referendum for such pur-
pose on December 8, 1958. On August 28, 1960 plans were ap-
proved by Florida State Board of Health for 1.4 MGD secondary
treatment plant with the related sewer extensions which would em-
brace the entire area within the corporate limits. This plant was
put into service in the fall of 1961 with dedication on December 29.

The Manatee River was by now free of all major pollution.
Route 301 highway construction through Ellenton in 1965 had de-
stroyed a major portion of its sewerage system with individual
septic tank installations following, removing its contribution
through abandonment.

Manatee County now has a total of 87 sewage treatment facili-
ties with treatment design capacities in excess of 6.8 MGD. These
include the two municipal plants previously mentioned with total
design capacity of 4.4 MGD, eleven subdivision systems with design
capacity in excess of 1.5 MGD, the balance, in excess of 0.9 MGD,
being for commercial establishments such as trailer parks, shopping
centers, restaurants, et cetera. In addition there are eleven operat-
ing industrial waste water treatment facilities which serve one
milk processing plant and the rest laundries. Through the con-
struction of the waste water treatment facilities noted above,
several sources of water pollution were corrected. This in addition
to supplying facilities for the expanding population which would
have, no doubt, contributed further to water pollution.

There are still water pollution problems in Manatee County, and
probably always will be, as it appears that one of man's basic bad
habits is to dispose of any and all types of waste by placing it in
the nearest waterway. The present pollution factors at Holmes
Beach it is believed will soon be eliminated as plans for Phase
I of this sewerage system were approved November 9, 1965.

Continuing progress is being made in determining instances
of pollution, locating the source and working towards abatement
thereof. This is evidenced by present surveillance of Sarasota Bay,
this area having been cleared for shellfish in 1965, and other pro-
grams presently being conducted on Wards Lake, Braden River,
Bishops Harbor, Terra Ceia Bay, and the new Manatee River Coun-
ty Reservoir.

Allen Kretschmar, Director

Sanitation Division

Manatee County Health Department

FLORIDA HEALTH NOTES

91

APPENDIX D-3c

Supplemental Report

Manatee County with 80,000 permanent population and 700
square miles is located on the Gulf of Mexico and Tampa Bay.
Until the rapid growth which began during the middle fifties,
water pollution was not a problem. There were no significant
polluting industries. Half of the people lived in Bradenton and
Palmetto which were served by adequate sewage facilities. The
rural and suburban population were sufficiently scattered and few
in number that their septic tanks and privies posed no problems.

In the past dozen years numerous trailer parks and subdivisions
have appeared in the suburban area. At first the policy of the
health department and county governing body was liberal in the
approval of septic tanks and their number and density reached
the point in the early sixties that approval was no longer freely
granted and a stronger stand was taken for sewage treatment
plants in new residential developments. The largest developments
already were served by such systems. The standards previously
reserved for large developments were applied to smaller and smaller
developments, and the present policy is to restrict septic tanks to
the situation for which they were always intended, isolated rural
homes. The health department cannot, of course, follow its policy
in every case at the practical, operational level.

Since 1959 there has been definite evidence of water pollution
problems in streams, rivers, drainage ditches, private wells and
bays, as evidenced by grossly visible pollution and also bacterio-
logical surveys and reports. The causes of the pollution appear
to be the density of septic tanks, septic tank failures, septic tanks
connected to storm sewers or otherwise lacking drainfields, dairy
manure and wastes, and, to a minor extent, industrial wastes. There
have been several instances of pollution by small businesses such
as laundries and, on a few occasions, by a very large citrus process-
ing plant. There are at this writing no other large industries
which have produced detectable pollution problems. At the present
time a factory which will produce triple superphosphate is nearing
completion and there is strong probability that an industrial com-
plex will develop in the Port Manatee area near this plant.

Since 1939, water supply to the City of Bradenton has been
the Braden River and there has been a good treatment plant. The
City of Palmetto supplies treated water from deep wells. Other-
wise, there is a very large number of private wells and 150 small
to large privately owned water companies. Manatee County will
soon open its water supply to all the suburban area. This water
will be taken from an impoundment on the upper Manatee River

92 • FLORIDA HEALTH NOTES

and will be treated. This new facility will greatly diminish private
wells and water supply companies and decrease some of the hazards
of water pollution.

Until November of 1965, Manatee County was served by a dis-
trict sanitary engineer of the State Board of Health and he also
served eight other counties. In November of 1965, the county em-
ployed a full time sanitary engineer and vigorously developed a
full scale program to cope with air and water pollution. Other
pollution control staff consists of a chemist, a laboratory tech-
nician, an engineering aide, a sanitarian, and a secretary. A pol-
lution control laboratory will be operational by October 1. A special
pollution control advisory committee appointed by the County
Commission Board has been functioning for about a year. Special
county enabling legislation for pollution control is being developed
for introduction in the next Legislature. County health department
personnel has increased from 14 in 1955 to 19 in 1960 and 42 in
1966. Sanitarians have increased from two in 1955 to five in 1960
and eight in 1966. Water pollution has never been a really serious
problem in Manatee County due largely to relatively small size and
lack of polluting industries. At this point, however, it is apparent
that water pollution would definitely become a serious problem with-
out controls. The Florida State Board of Health has provided vigor-
ous extensive assistance to the Manatee County Health Department
in dealing with all of the relatively minor problems transpiring in
the past and also in establishing the present specialized pollution
control program. The assistance has many times involved the
State Health Officer, the legal staff, and especially the Bureau of
Sanitary Engineering. In every case, the State Board of Health
has promptly provided whatever and all help needed to solve all
pollution problems which developed in Manatee County. This help
was invariably effective in acute, more severe problems and, over
the years, has staved off the worsening of water pollution.

After years of effort, only recently has the Board of Health
convinced the public of the truly serious implications of the pollu-
tion problem and not even yet has the Legislature found sufficient
funds to operate the kind of effective program the public now
demands. To create a new state agency to control pollution rather
than to finally provide the Board of Health with sufficient financial
support seems political rather than expedient particularly as such
action will have the effect of ignoring an excellent, functioning
administrative system and ignoring years of sound experience and
ignoring scores of well trained specialists in the field. Let us pass
sufficient laws and provide sufficient monies and let the Board of
Health continue to do a good job.

George M. Dane, M.D.

Director

Manatee County Health Department

FLORIDA HEALTH NOTES

93

APPENDIX D-4

September 8, 1966

Re: Water Pollution
General

Mr. David B. Lee, Director
Bureau of Sanitary Engineering
Florida State Board of Health
P. O. Box 210
Jacksonville, Florida 32201

Dear Mr. Lee:

This is in reference to your memorandum of August 24, 1966
requesting an opinion from this office relative to the status of our
water pollution control program and specifically to the progress
which has been made during the 20 year period 1947-67.

I have given careful consideration to this matter and feel that
significant progress has been made in this county. Eecognizing
that this information will be used in a forthcoming issue of Health
Notes, I have chosen to highlight several of what I consider to
be the more dramatic developments.

The first of these is the development of central sewerage sys-
tems. In 1946 Hillsborough County had no approved central sys-
tems; today 296,085 people are served by approved municipal or
private systems. In 1946 there were no approved waste treatment
plants in Hillsborough County; today we have 97 such plants.

There are three incorporated municipalities in Hillsborough
County — Tampa, Temple Terrace and Plant City. In Tampa ap-
proximately 85 per cent of the population is served by the sewerage
system ; in Temple Terrace approximately 95 per cent, and in Plant
City, approximately 80 per cent.

Modern waste treatment for our public schools is another ac-
complishment in Hillsborough County in which we take great pride.
We have approximately 100,000 students who attend 127 schools.
Of these 127 schools, all except 12 are either on sanitary sewers
or have their own approved aerobic sewage treatment plants. Sev-
eral of the 12 remaining schools on septic tanks will be provided
with sewage treatment plans in the very near future. A review of

94 • FLORIDA HEALTH NOTES

the correspondence will reveal that the Division of Waste Water,
along with our department, played a great part in convincing the
School Board to provide sewage treatment plants rather than septic
tanks.

We expect this trend toward central sewerage facilities to ac-
celerate rapidly during the next few years. The Hillsborough Coun-
ty Board of County Commissioners are at this time making firm
plans to provide central water and sewerage facilities to the un-
incorporated areas of the county.

The second item of special interest is the progress which has
been made by the Lykes Brothers Meat Processing Company. In
1946 the Lykes Brothers Tampa plant dumped all of its waste un-
treated into the Palm River at a point near its entrance into McKay
Bay. The result was gross pollution. Several years ago the Lykes
plant was connected to the City of Tampa system and this ex-
tremely acute problem alleviated. Lykes Brothers has recently
completed another meat packing plant near Plant City. This out-
standing facility is said to be the largest of its type south of
Chicago and the most modern in the world. The waste treatment
plant which was constructed to serve this facility is of the most
modern design and utilizes the latest technological advances in
waste treatment methods. The cost is approximately $300,000. In
my opinion this is dramatic progress.

I hope the above information will be of help in the preparation
of the forthcoming issue of Health Notes. If I can be of further
assistance, please call on me.

Yours very truly,

Donald W. Rogers, P.E.
Director of Sanitary Engineering
Hillsborough County Health Department

FLORIDA HEALTH NOTES

95

APPENDIX D-5

September 21. 1966

Mr. David B. Lee, Director
Bureau of Sanitary Engineering
State Board of Health
P, 0. Box 210
Jacksonville, Florida 32201

Dear Mr. Lee :

The following is a report of the progress of Pinellas from 1947
to 1966. Emphasis is placed on growth of public water supplies
and municipal type sewage treatment facilities.

Approximately 90% of the population of 430,000 has access to
sewer systems and public water supplies.

A high quality of leadership, conscious of the needs for clean
water, was necessary in order to maintain the recreational waters
bordering Pinellas County.

There is little doubt that within the past 14 years Mr. William
E. Dunn has assumed a major role in the leadership of water
quality control. Mr. Dunn worked 12 years in Pinellas County as
director of the Environmental Health Program and was dedicated
to the establishment of sewer systems and public water supplies.
His most recent endeavors, the establishment of county-operated
sanitary districts, has caused him to leave the County Health De-
partment and assume the operation of the sanitary districts as
well as continue to establish new districts. Without his efforts in
Pinellas County, or without the efforts of an equally dedicated
Health Department employee, the county would probably have fal-
len far short of goals which it has attained today.

Very truly yours,
Harold Leadbetter
Sanitary Engineer
Pinellas County Health Department

RCG/wl
Attachments

96 • FLORIDA HEALTH NOTES

The facts in this report are extracted from a 20-page report
submitted to the director of the Bureau of Sanitary Engineering
by the sanitary engineer of Pinellas County Health Department.

Tierra Verde

This island community is served by two Marolf aeration plants
of 30,000 gallons per day. Plans call for a three-phase expansion
program of the sewage treatment plant which would have 100,000
GPD for each phase.

Fort DeSota Park

This county park is served by five aeration plants throughout
the park which is completely sewered. Two of the plants are due
for expansion,

GULF BEACHES

St. Petersburg Beach

Twenty years ago the area was served by septic tanks. The
first sewer lines and primary sewage treatment plant was in-
stalled in 1959 with 1.8 MGD design flow. In 1966, a secondary
treatment plant was put into full use which is designed for a peak
flow of 3.33 MGD. A total of 100 per cent of the platted area
is served by the treatment plant known as Long Key Sewer Dis-
trict. This district was taken over by the St. Petersburg Beach
in November 1966.

Treasure Island

Septic tanks served this city until sewer lines and sewage treat-
ment facilities were installed in 1950. The treatment plant was
expanded in 1956-57 and again in 1964 and converted to a contact
stabilization sewage treatment plant. The present capacity is
2.2 MGD.

Madeira Beach

In 1947 the area was unsewered but a primary sewage treat-
ment plant was constructed in 1952. It was redesigned and en-
larged in 1959 to 2.2 MGD with a 27 per cent BOD removal. At
the present time, the city engineers are preparing a feasibility
study on their sewage treatment facilities and may recommend
consolidation with another sanitary district.

Indian Rock Beach, South Shore

This area was served by septic tanks until a Hi-Cone activated
ludge sewage treatment plant was put into operation in 1959.
U this time the entire platted city was sewered. In 1966, this
ewage treatment plant is operating at approximately 10 per cent
f design capacity.

FLORIDA HEALTH NOTES

97

Indian Rock Beach

This area is sewered by the McKay Creek Sanitary District.
Prior to 1966 it was on septic tanks.

Belleair Beach and Belleair Shores

The area is unsewered but applications have been made for
federal money to finance sewers.

PINELLAS PARK

In 1947, the area was served by septic tanks. The first sewer
lines were laid in 1957 with four lift stations to pump sewage to
a plant. In 1960, a conventional activated sludge sewage treatment
plant of 1.0 MGD design flow was completed. In 1963 the sewage
treament plant was enlarged and additional sewers and lift stations
added. Further expansion is planned by 1970.

ST. PETERSBURG

In 1947, the city had no sewage treatment. However, sewers
were located in the downtown area which emptied into Tampa Bay
after screening and chlorination. The first treatment plant was
completed in 1954 and about 25 per cent of the city sewered. Three
more primary treatment plants were added in 1956 and 1957 with
approximately 50 per cent of the city sewered. In 1965-66, two
of the sewage treatment plants were converted to modified activat-
ed sludge and the design capacity enlarged. All of the platted
areas within the city are sewered. This is a part of a capital
improvement program which includes storm drains, paving streets,
lighting, widening streets, larger water and sewer trunk lines and
beautification.

County Sewer Districts

Pinellas County has completed or in the process of constructing
seven sanitary districts which will serve about 82,600 persons with
at least three sewage treatment plants and a capital outlay of
$13,370,000 (for six districts) plus money acquired from general
funds. The South Cross Bayou Sanitary District will have a 5
MGD design capacity plant which will serve the Pinellas County
(Kenneth City), Boca Ciega, and Jungle Terrace Sanitary Dis-
tricts; McKay Creek Sanitary District plant will have 800,000
gallons per day capacity and the Pinellas County Sewer System
(Virginia Groves) will have a 100,000 gallons per day plant. A
privately-owned sewage treatment plant is also operated in the
Boca Cie^a Sanitary District by the Bay Pines Estates.

98

FLORIDA HEALTH NOTES

LARGO

In 1947, Largo was served by a septic tank and aewers in the
downtown area. The first sewer lines were laid in 1925. The first
primary sewage treatment plant was completed in 1954 and the
city was 50 per cent sewered. The present plant of 1.5 MGD de-
sign flow was completed in 1962, The Newport Sewage Treatment
plant was purchased in 1966 by the city and with mechanical reno-
vation it will be tied into a master lift station. It is estimated that
by 1968 all of the recently annexed areas will be sewered. Further
plant expansion will be necessary by 1970.

BELLEAIR

In 1961-62, Belleair constructed a modern Chicago Pump-Hi-
Cone Aeration Plant of 0.5 MGD design capacity at an estimated
cost of $1.25 million.

CLEARWATER

In 1947, the city had municipal septic tanks and one primary
treatment plant which was built in 1939. In 1966, Clearwater is
served by three extended aeration plants with a total design flow
of 6.5 MGD. A total capital outlay of $17.5 million has been spent
in the past 20 years and one plant is being expanded from a million
gallons flow per day to 5.0 MGD at a cost of $1,845 million.

SAFETY HARBOR

In 1947 the city was on municipal septic tanks with 50 per
cent of the city sewered. In 1955, Safety Harbor constructed a
Spirahoff Treatment plant and in 1962 the municipality built a
secondary trickling filter plant with a 0.35 MGD design flow.

DUNEDIN

In 1947, Dunedin was served by municipal septic tanks and 35
per cent of the city was sewered. A primary sewage treatment
plant was built in 1957 and 95 per cent of the city was on sewers.
By 1966, the primary sewage treatment plant had been expanded
to 3 MGD peak flow with a digester and clarifier added. In the
immediate future, the city plans to expand the primary sewage
treatment plant to a secondary plant, construct a permanent ex-
tended aeration plant and install more interceptors and li*"t stations.

FLORIDA HEALTH NOTES

99

TARPON SPRINGS

The city was served by three 15,000 gallons municipal septic
tanks in 1947 and 50 per cent of the city was on sewers. The first
primary sewage treatment plant was built in 1951 and at that time
the city was 95 per cent sewered. A 1960 feasibility study of
sewage treatment has never been augmented but a budget request
for another study was due to go before the City Council late in
1966.

OLDSMAR

In 1964, the city purchased the existing sewage treatment plant
from County Club Estates for $90,000 and floated a bond issue to
pay off old water bonds and finance a modern secondary sewage
treatment plant, sewer lines and lift stations at a cost of $512,000.
The city has also received a federal grant of $141,000 as an aid
in pollution control.

Stream Pollution

A minimum of three surveys are made annually of five streams,
three major lakes, several small lakes, and eight bays and bayous.
Dissolved oxygen, salinities or bacteriological analyses are made
during each survey. St. Joseph's Sound and Mullet Key areas re-
ceive 15 complete samplings during 1966.

Industrial Wastes

Industrial waste has not been a large problem in Pinellas Coun-
ty. Communities have developed by the influx of retired families
and tourist trade. Unlike Tampa, which relies heavily upon in-
dustry, St. Petersburg and the other cities in Pinellas County
have remained mostly residential in nature.

Light industry is present and plating wastes from small plating
companies is the major source of industrial waste. A recent move
to raise the standard of the effluent emitted by these sources has
been put into effect with the assistance and guidance of the Di-
vision of Industrial Waste, Florida State Board of Health.

100

FLORIDA HEALTH NOTES

APPENDIX D-6

September 20, 1966

TO: David B. Lee, P. E., Director

Bureau of Sanitary Engineering
Florida State Board of Health

FROM: Lawrence D. Lukin, P. E.

Director of Environmental Health

SUBJECT: Palm Beach Comity

Stream Pollution

This report is aimed at reflecting the progress made in the
last two decades toward abatement of water pollution in Palm
Beach County. We should bear in mind that a direct comparison
using the identical parameters would naturally mislead in the in-
terpretation of end results. Twenty years ago the indexes of pol-
lution and the uses of water were appreciably different than they
were 40 years ago, and more so 60 years ago and so on. A measure
of progress then should be based not only on the engineer's indexes
of the 1940*s but also by the changing environmental demands of
the 1960's.

We can capsulate the changing abatement criteria into two
major categories:

A. The indexes of measurement of pollution.

B. The degree of tolerable pollution.

A. The Indexes:

The engineer has selected his yardstick wisely in M.P.N. 'a,
D.O.'s, B.O.D's, etc. in that the collection of samples, labora-
tory work and interpretation of results are simple and in-
expensive. The coliform organism count has had universal ac-
ceptance as an association with pathogens on the basis of
"Guilt by Association."

New acquaintances to the engineer, namely the ecologist,
pathobiologist, and microbiologist have suggested the need
for more specific indexes of pollution. The ecologist points
out the more reliable index of pollution is the biomass that
lives in the streams or bodies of water. Changes in the eco-
logical system are more sensitive measures of pollution com-
pared to the grab samples favored by the engineer. The fish,
crustacea, plankton, etc. are continuous samplers of the water
quality.

FLORIDA HEALTH NOTES

101

We should also ask:

Is the potential of transmission of disease limited to the
bacteriological concentrations? Only recently has suspicion
of the microbacteria become implicated in transmission via
the water route. The survival of the viruses after destruction
of the coliforms challenges the current indexes of pollution.

B. The Degree or Tolerable Pollution

What degree of treatment and subsequent pollution load on
a stream represents adequate protection to the broad environ-
ment? The answer to this question reaches beyond the public
health aspects of the human animal. We are confronted more
and more each year with the demands of the conservation
people and the game and fresh water fish interests. If we
agree to recognize the aims of these groups, then our current
standards of tolerable pollution will have to be upgraded.
Progress in Water Pollution in Palm Beach County is best
measured by classifying the many areas of activity and weigh-
ing them on their individual balances rather than the program
as a whole. Below is a categoric comparison showing progress
in three degrees of accomplishment in the last 20 years.

I. Areas of Significant Progress

A. Extension of municipal sewage treatment.

B. Upgrading of new and existing treatment facilities to ter-
tiary treatment or ocean outfall systems.

II. Areas of Minor Progress

A. Subdivision curtailment on septic tank systems.

B. Industrial waste discharges.

HI. Areas of Stagnancy or Digression

A. County-wide planning.

B. Expansion of staff and personnel to meet the growing en-
vironment.

C. Legal assistance on a county level.

D. Upgrading of privately owned sewerage facilities.

102

FLORIDA HEALTH NOTES

APPENDIX E

"Health Aspects of Water Pollution"
from Weekly Compilation of Presi-
dential Documents, Monday, Septem-
ber 5, 1966, Vol. 2, No. 35. pp. 1155-
1205.

FLORIDA HEALTH NOTES

103

HEALTH ASPECTS OF WATER POLLUTION CONTROL

Interdepartmental Agreement Concerning Consultation Between
Departments of Health, Education, and Welfare and the Interior.
September 2, 1966

1. This Interdepartmental Agreement has been developed in ac-
cordance with the provisions of Section 1(f) of Reorganization
Plan No. 2 of 1966, which states :

"The functions of the Surgeon General under Section 2(k) of
the Water Quality Act of 1965 (79 Stat. 905) are transferred to
the Secretary of Health, Education, and Welfare. Within 90 days
after this reorganization plan becomes effective, the Secretary of
the Interior and the Secretary of Health, Education, and Welfare
shall present to the President for his approval and interdepart-
mental agreement providing in detail for the implementation of
the consultations provided for by said Section 2(k). Such inter-
departmental agreement may be modified from time to time by
the two Secretaries with the approval of the President."

2. The functions referred to above are defined by Section
2(k) of the Water Quality Act of 1965, as follows:

"The Surgeon General shall be consulted by the head of the
Administration on the public health aspects relating to water pol-
lution over which the head of such Administration has administra-
tive responsibility."

3. The public health aspects of water pollution relate to man's
drinking water ; to his contact with water in recreation and work ;
to the contamination of food sources, particularly shellfish; and
to the breeding of specific insect vectors of disease. The health
threat is of three types ; (a) chemical — both organic and inorganic
contaminants, which can result in acute toxic or long-term chronic
effects on humans; (b) biological — microbiological contaminants
and insect vectors associated with spread of communicable disease;
and (c) radiological — radioactive contaminants which in very low
level concentrations may produce radiation damage in humans.

4. Consultation between the Departments of Health, Educa-
tion, and Welfare and the Interior under the terms of this Agree-
ment shall be based upon the following general concept:

(a) The Department of the Interior is responsible for ad-
ministering the Federal Water Pollution Control Act as amended;

104 • FLORIDA HEALTH NOTES

ertain functions relating to water pollution control under Section
702(a) of the Housing and Urban Development Act of 1965, Sec-
tion 212 of the Appalachian Regional Development Act of 1965,
and Section 106 of the Public Works and Economic Development
Act of 1965, and Executive Order 11288, "Prevention, Control, and
Abatement of Water Pollution by Federal Activities."

The stated purpose of the Federal Water Pollution Control Act
is "to enhance the quality and value of the nation's water resources
and to establish a national policy for the prevention, control, and
abatement of water pollution." The responsibilities of the Depart-
ment of the Interior, under the above legislation and Executive
Order, involve the prevention and control of water pollution in
consequence of the benefits resulting to the public health and
welfare, giving due regard to the improvements which are neces-
sary to conserve the nation's waters for public water supplies,
propagation of fish and aquatic life and wildlife, recreational pur-
poses, and agricultural, industrial, and other legitimate uses. To
meet these responsibilities the Department of the Interior, through
the Federal Water Pollution Control Administration, conducts pro-
grams to identify and measure the extent of pollution and its ef-
fects on water uses and to assure the treatment and control of
waterborne wastes.

(b) The Department of Health, Education, and Welfare, under
the Public Health Service Act as amended, is responsible for the
protection of the public health. Within this responsibility, the De-
partment through the Public Health Service is, therefore, concern-
ed with the causes, diagnosis, treatment, control and prevention of
physical and mental diseases and impairments of man. As related
to Reorganization Plan No. 2, these responsibilities include: de-
termination of the health significance of water pollution; investi-
gation of waterborne diseases and means for their control; pro-
vision of consultation to the Department of the Interior on the
public health aspects of water pollution; and advising on the public
health questions involved in the inclusion of storage for water
quality control in Federal reservoirs.

5. Under the terms of this Interdepartmental Agreement the
Apartment of Health, Education, and Welfare will provide advice
the Department of the Interior as follows :

(a) Recommendations on criteria for water quality standard
etting based on health aspects of intended water use for drinking

FLORIDA HEALTH NOTES

105

water supplies, shellfish and other marine food production, bath-
ing, and other water contact activities. Recommendations will be
provided and modified as new supporting data are developed.

(b) Upon request, consultation and technical assistance on spe-
cific water-related health problems, as these may arise in connec-
tion with water pollution control activities, such as comprehensive
pollution control program, enforcement actions, control of pollu-
tion from Federal installations, water pollution research projects,
construction grants, and the study of water pollution from vessel
operations. In cases where epidemiological surveillance activities
indicate that a probable public health hazard exists, the Public
Health Service will initiate appropriate action to advise the Federal
Water Pollution Control Administration.

(c) Review and comment on construction grant applications
and on requirements for control of pollution from Federal installa-
tions for specific projects whose operation may adversely affect
the sanitation of shellfish-growing waters. The Federal Water
Pollution Control Administration will refer all such projects to the
Public Health Service for review and comment.

6. Section 1 (e) of Reorganization Plan No. 2 of 1966 provides
for the Department of Health, Education, and Welfare to advise
on public health questions involved in determinations by Federal
agencies of the need for and value of the inclusion of storage for
water quality control in Federal reservoirs. Advice on the effects
of streamflow regulation on public health will be provided by the
Public Health Service based upon the studies prepared by the
Federal Water Pollution Control Administration under Section 3(b)
of the Federal Water Pollution Control Act. The Federal Water
Pollution Control Administration report will be provided to the
Public Health Service for review and comment. The Public Health
Service comments, together with its own report on the production
of disease transmitting insects and other environmental health
considerations in the project area, will be submitted to the Federal
construction agency concerned.

7. To assure an adequate basis for such advice and consultation
to the Department of the Interior, the Department of Health, Edu-
cation, and Welfare will, through the Public Health Service, con-
duet the following kinds of studies on the health aspects of water
pollution:

(a) Epidemiological, microbiological, radiological, and toxicol-
ogical research and investigations into the human health signifi-

106 • FLORIDA HEALTH NOTES

cance of waterborne contaminants, to determine health tolerance
for such contaminants as they affect drinking water supplies, shell-
fish and other marine foods production, and water contact activities,

(b) Epidemiological surveillance of the incidence of waterborne
disease based on disease reporting, and on health-related water
quality data derived from the Public Health Service drinking water
quality network established under the Interstate Quarantine Regu-
lations, the National Shellfish Sanitation Program, and the Radia-
tion Surveillance Center, and on data from the program activities
of the Federal Water Pollution Control Administration.

Investigation of waterborne disease outbreaks will be conducted
in cooperation with State and local health departments. Data and
participation will be requested from the Federal Water Pollution
Control Administration when water pollution is involved in the
outbreak. Reports based on these investigations which identify
pollution that presents a danger to health will be referred to the
Federal Water Pollution Control Administration for appropriate
action.

(c) Studies of the relationship of surface water characteristics
to the production of disease vectors such as disease-transmitting
insects, snails, and protozoa.

(d) Development of techniques for the identification, measure-
ment and study of the behavior of waterborne contaminants which
cause or influence disease, such as viruses, bacteria, organic chemi-
cals, and trace elements. The results of these Public Health Serv-
ice studies will be made available to the Federal Water Pollution
Control Administration as a complement to its studies on identi-
fication and measurement of water pollutants, the results of which
in turn will be made available to the Public Health Service.

Study of methods of removing contaminants of health signifi-
cance to meet human tolerance levels as related to drinking water,
swimming pools, shellfish depuration, and food processing. To
avoid duplication of Federal installations for pilot plants, when
such facilities are required to study methods of removing con-
taminants from drinking water, Public Health Service personnel
may use Department of the Interior facilities. To assure that such
installations will adequately serve such purposes, the Department
of the Interior shall consult with the Department of Health, Edu-
cation, and Welfare in their design.

Study of the human health relationship of waterborne con-
minants to animals and plants used as sources of foods, such as
'ellfish and other marine foods, food crops irrigated with polluted
ater, including their field packaging, and use of sewage sludge

a fertilizer and soil conditioner.

FLORIDA HEALTH NOTES

107

8. The Public Health Service and the Federal Water Pollution
Control Administration will exchange on a regular basis relevant
health-related water quality data and research results. Particular
attention will be given to prompt exchange of significant new find-
ings which would affect the program responsibilities of either
agency.

9. To effect essential coordination between Public Health Serv-
ice and the Federal Water Pollution Control Administration, and
to insure fulfillment of this agreement, each agency will designate
an official liaison representative. These representatives, together
with appropriate staff, shall meet at the request of either agency
to discuss measures taken to implement this agreement and review
any evident or emerging technical, administrative or fiscal prob-
lems which either agency considers might affect the proper func-
tioning of this agreement. Any unresolved problems will be brought
to the attention of the respective Secretaries.

John W. Gardner

Secretary of Health, Education, and Welfare

August 8, 1966

Stewart L. Udall
Secretary of the Interior
August 8, 1966

Lyndon B. Johnson
The President
September 1, 1966

108 • FLORIDA HEALTH NOTES

APPENDIX F

(1) Letter from Wilson T. Sowder,
M.D., Florida State Health Of-
ficer, to H. B. Cottrell, M.D.,
Regional Health Director, U. S.
Public Health Service, Region
rv, Atlanta, Georgia.

(2) Letter from Howard W. Chap-
man, associate regional health
director, for Environmental
Health Service, U. S. Public
Health Service, Region IV, At-
lanta, Georgia, to Wilson T.
Sowder, M.D., Florida State
Health Officer.

FLORIDA HEALTH NOTES

109

APPENDIX F (1)
August 12, 1966

H. B. Cottrell, M.D.

Regional Health Director

U. S. Public Health Service — Region IV

50 Seventh St., N.E.

Atlanta, Georgia 30323

ATTENTION: Mr. Howard Chapman

Dear Doctor Cottrell :

Enclosed is a copy of a recent memo of mine concerning the
Florida State Board of Health's interest in an improved public
information program, especially on air and water pollution control
programs. I am bringing this to your attention because I think
it would be helpful to the Florida State Board of Health to obtain
your thoughts and assistance on this matter.

In particular, I would like to request a very brief report com-
paring Florida pollution problems and control programs to other
states in your region or perhaps to the rest of the country. If you
can meet this request, I think you would satisfy our needs by limit-
ing your response to an evaluation and comments on materials,
information, and impressions you already have on hand. I know
this may restrict you to making only general observations; how-
ever, I do not believe our situation or public information purposes
warrant anything more than that at this time. Your permission
to publicly quote any of the comments you may be able to send
will be appreciated.

Sincerely,

Wilson T. Sowder, M.D.

State Health Officer

WTS:mw
Enc.

110

FLORIDA HEALTH NOTES

APPENDIX F (2)

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

Regional Office
PUBLIC HEALTH SERVICE

Bin. 404, 50 Seventh Street, N.E.
Atlanta, Georgia 30323

Dr. Wilson T. Sowder
State Health Officer
State Board of Health
Jacksonville, Florida 32201

September 6, 1966

Dear Dr. Sowder:

This is in regard to your letter of August 12 to Dr. Cottrell,
requesting a brief report on Florida's water and air pollution prob-
lems and control program. Enclosed with your letter was a copy
of your July 28 memorandum to County Health Officers, etc. on
"Information Program and Legislative and Budgetary Proposals
on Air and Water Pollution Control Programs", and a copy of the
proposed act "State Environmental Control Act."

To comply with your request it is necessary to treat air and
water pollution separately, as follows :

Water Pollution

In general, the Florida State Board of Health has done an
excellent job in obtaining treatment of wastes from municipalities.
The statistics on the number of municipal waste treatment plants
built in the State of Florida during the last few years are, indeed,
most impressive. During the period 1961 through 1965, 1003 sepa-
rate treatment plants were approved for construction. No State
within this Region, and only a few nationally, have had the rate
of population growth and urban expansion, with its accompanying
municipal waste problem, as has Florida.

The State Board of Health has carried out some extensive
studies on special local water pollution problems such as those as-
sociated with the phosphate industry. These studies are com-
r endable, but staff resources should be available to cover all
i; dustrial wastes and stream problems in the State.

One of the real glaring weaknesses in Florida is State law
1 lieh exempts certain industrial areas from pollution control. No

FLORIDA HEALTH NOTES

111

State in the Southeast has similar exemptions in its law. Also, as
in other States, Florida has serious pollution problems relating to
the larger municipalities such as Jacksonville and Miami.

In the "Staffing and Budgetary Guidelines for State Water
Pollution Control Agencies," prepared by the Public Administra-
tive Services, Chicago, Illinois, (see enclosed copy) it is suggested
that Florida have a minimum staff of 58 persons, but a staff of
93 persons for its water pollution control program would be more
desirable. To support this staff a minimum annual budget of
$528,000 would be required, and a desirable budget of $847,000.
Florida's present staff and budget is less than one-half of the
minimum recommended.

The Florida State Board of Health has an effective water pol-
lution control program which has done much to control or mini-
mize pollution in the State. However, to cope with the pollution
problems associated with population growth, urban and industrial
expansion, etc., the following is needed :

1. Strong legislation providing all the authority needed to do
a complete job.

2. Adequate budget and staff.

3. Initiate long-range planning for water pollution control
which includes a comprehensive approach for stream studies
and abatement of pollution from all municipalities and in-
dustries.

Air Pollution

Based on 1965 data, the Florida State Board of Health spent
approximately $176,000 for air pollution activities or approxi-
mately 3.5 cents per capita per year. The average in 35 States
during the same year was 4 cents. However, this comparison of
Florida with other States is somewhat misleading since approxi-
mately $146,000 of the $176,000 was spent in the Polk-Hillsborough-
District, leaving only $30,000 for the remainder of the State. There-
fore, the per capita per year expenditure in the Polk-Hillsborough
District was about 23.4 cents, and the remainder of the State 0.6
cents. If the Polk-Hillsborough District is considered a "local"
program, the expenditure of 23.4 cents per capita compares favor-
ably with the 1965 average of 22.6 cents for 130 local programs.
Obviously, the 0.6 cents per capita for the State's activities is much
below the national average of 4 cents. In general, a comprehensive
State air pollution program that includes studies, technical as-
sistance to local programs, plan review and approval, and enforce-
ment authority should have a minimum budget of from 2-5 cent^
per capita per year.

112 • FLORIDA HEALTH NOTES

Unquestionably, the State program and activities in the Polk-
lillsborough District have effectively reduced air pollution emis-
ions in this area. This has been accomplished even though there
nas been a tremendous expansion of the phosphate rock processing
industry within the last eight years. It is generally agreed, how-
ever, that the air pollution problems are not completely resolved
and much additional effort is needed. The Florida State Board of
Health is fortunate in having on its staff engineers who are na-
tionally recognized for their expertness in the field of air pollu-
tion control from phosphate rock processing operations.

I would like to comment briefly on the proposal for $1,000,000
in grants for local air and water pollution control programs, as
well as the proposal to shift $500,000 from the State program to
the local program — providing, in all, $1,500,000 for local activities.

State grants to the more populated Counties, or to Counties
that have special or unusual problems, may be appropriate and
should be productive. According to the 1960 census, there were
11 Counties in the State with populations in excess of 100,000 and
10 with between 50,000 and 100,000. It is doubtful that Counties
with less than 50,000 population would have the resources, interest,
or variety of staff to mount a successful program in either the
water or air area. I would, therefore, suggest that if grants are
to be made to County health departments that specific criteria or
guidelines be developed and followed which would exclude grants
to Counties where it is doubtful a meaningful program could be
established, and where it is evident that the State could provide
the services better and more economically.

In addition, it is imperative to have a clear understanding of
the State and County health department roles. The local program
should supplement and complement the State's program. The
State program should continue to have the responsibility for labo-
ratory services, setting of standards, provision of expert technical
services, comprehensive long-range planning and enforcement.

Sincerely yours,

Howard W. Chapman

Associate Regional Health Director

for Environmental Health Services

FLORIDA HEALTH NOTES

113

WHAT ARE WATER POLLUTANTS?

Sewage

Infectious organisms

Plant nutrients — nitrogen and phosphate fertilizers

Organic chemicals exotics — detergents, insecticides,
pesticides, herbicides, DDT, 100 synthetic organic in-
secticides, inorganic pesticides

Mineral and chemical substances — salts and acids
Soil sediments

Radioactive substances
Heat

WHO OR WHAT ARE WATER POLLUTERS?

Air Force bases

Airlines

Army bases

Banks

Beauty and barber shops

Bootleggers

Bus stations

Chemical plants

Churches

Citrus growers

Commercial ships

Dairy farmers

Distilleries

Electrical generating stations

Garages

Golf courses

Homeowners

Hospitals

Indian villages

Industrial plants

Insurance offices

Lumberyards

Motor boats

Muck farmers

Naval vessels and installations

Paper and pulp mills

Phosphate mining and processing plants

Railroad trains

Rendering plants

Restaurants

Schools, colleges and universities

Septic tanks

Sewage treatment plants

Slaughterhouses

Soft drink bottlers

State office buildings

State hospitals and institutions

Stores

Swimmers

Well drillers

Zoos

THESE ARE ONLY A FEW OF THE
POLLUTERS BUT THE LIST IN-
CLUDES . . .

Everybody

People fish and water ski on Duval County's Cedar Creek despite the fact
that it is polluted.

♦**

fuj*i59-No.2 fa fight For

Ht>ARY 1967 CLEAN AIR

*uOft- vatfJWE

WHAT ARE WATER POLLUTANTS?
Sewage

Infectious organisms

Plant nutrients — nitrogen and phosphate fertilizers

Organic chemicals exotics — detergents, insecticides,
pesticides, herbicides, DDT, 100 synthetic organic in-
secticides, inorganic pesticides

Mineral and chemical substances — salts and acids
Soil sediments

Radioactive substances
Heat

WHO OR WHAT ARE WATER POLLUTERS?

Air Force bases

Airlines

Army bases

Banks

Beauty and barber shops

Bootleggers

Bus stations

Chemical plants

Churches

Citrus growers

Commercial ships

Dairy farmers

Distilleries

Electrical generating stations

Garages

Golf courses

Homeowners

Hospitals

Indian villages

Industrial plants

Insurance offices

Lumberyards

Motor boats

Muck farmers

Naval vessels and installations

Paper and pulp mills

Phosphate mining and processing plants

Railroad trains

Rendering plants

Restaurants

Schools, colleges and universities

Septic tanks

Sewage treatment plants

Slaughterhouses

Soft drink bottlers

State office buildings

State hospitals and institutions

Stores

Swimmers

Well drillers

Zoos

THESE ARE ONLY A FEW OF THE
POLLUTERS BUT THE LIST IN-
CLUDES . . .

Everybody

People fish and water ski on Duval County's Cedar Creek despite the fact
that it is polluted.

*L ,-.

' .'--,

FLORIDA

HEALTH
NOTES

)F iOA^tATE BdfcftD

f me s» -ho. 2 The Fight For

«b ary 1967 CLEAN AfR

__

mmmm\\v&

>*M

■_:■*

*ii

Groves stretch to the horizon in
orange -growing country of Central
Florida. Cleon air is a requirement
for such agricultural pursuit. (Cover
photograph) An electrical power
generating station eructates gase-
ous fumes into the skies of a Florida
seaport.

^k

FIGHT

Jot

CLEAN
AIR

w$$

FLORIDA HEALTH NOTES

Published monthly by the Floridb State Board of Health, Wilson T. Sowder, M.O., M.P.H.,
Stat* Health Officer. Publication office Box 210, Jacksonville, Florida 32201. Second clou
postage paid of Jacksonville. Florida. This publication is for individual* and Institutions with
an interest in the state's health programs. Permission is given to quote any story providing
credit is given to the Florida State Board of Health Editor: Robert A. Schoonover, M.A.,
Division of Health Education.

VOLUME S9 — NO. 2

FEBRUARY 1«7

FLORIDA HEALTH NOTES

119

Groves stretch to the horizon in
orange -growing country of Central
Florida. Clean air is a requirement
for such agricultural pursuit. (Cover
photograph) An electrical power
generating station eructates gase-
ous fumes into the skies of a Florida
seaport.

5Sfe

FIGHT

CLEAN
AIR

FLORIDA HEALTH NOTES

Published monthly by the Florida State Soord of Health. Wilson T. Sawder. M.D., M.P H,,
>tate Health Officer. Publication office. Box 210, Jacksonville, Florida 32201. Second class

astage paid of Jacksonville, Florida. This publication is for individuals and institutions with
jn interest in the state's health programs. Permission is given to Quote any story providing

'edit is given to the Florida State Board of Health. Editor: Robert A. Sehoonover. M.A
>ivision of Health Education.

VOLUME 59 — NO. 2

FEBRUARY 1967

FLORIDA HEALTH NOTES

119

TABLE OF CONTENTS

Page

Introduction 121

State Board of Health's Authorization 124

What is Air Pollution? 125

Sources of Pollution — - - 126

Florida Has Some Air Pollution Problems - 128

A Major Problem — The Phosphate Industry 131

The Florida Air Pollution Control Commission 133

Activities of the Air Pollution Control District 134

Enforcement of Rules and Regulations 136

Agricultural and Phosphate Interests 138

Statewide Pollution Control Activities 139

Air Pollution is Health Problem 144

Help for the People 146

Financing and Personnel — 149

Legal Action by the State Board of Health 150

Health and Economic Factors - 151

SELECTED BIBLIOGRAPHY . „ 154

APPENDICES _ 155

Appendix A— "The Health Effects of

Air Pollution in Polk County" 155

Appendix P. — Letters from Wilson T. Sowder, M.D.,
Florida State Health Officer and Howard W,
Chapman, associate regional health director
for environmental health, U. S. Public Health
Service, Region IV .. 169

120 • FLORIDA HEALTH NOTES

The Fight For Clean Air

Have you ever breathed pure air in your life? That's right,
have you? There has always been some pollution, even in nature,
but today's public health and government officials, plus millions
of Americans, are concerned about the amount of dirt escaping
into the air we breathe. When the amount of this matter in the
atmosphere interferes with your comfort, safety, health or the
full use and enjoyment of your property, it is called air pollution.

Some examples of air pollution which have turned up as com-
plaints with the State Board of Health during one six-month
period were: 1

* paint damage from particulate deposits originating from a
utilities plant

* dust and smoke from a tung mill

* dust fumigation from a nearby pulp mill.

* dense smoke from a laundry before it switched from fuel
oil to natural gas

* annoying odors from a chemical plant

* deterioration of sheet metal roof from hydrogen sulfide

* air pollution from a sandblasting operation

* creosote odors from a lumber and wood treating company

* dust and odors from an asphalt plant

* airborne particulate matter from a fertilizer plant

There have been innumerable complaints concerning damage to
livestock, citrus groves, ornamental plants, flowers, and automobile
paint.

Air pollution is becoming a problem. As the population grows
and more people are born in and migrate to the cities, the air
pollution threat can only grow more acute. Some experts agree
with, but view as extreme, the statement by Los Angeles meteor-

'■ "Statewide Air Pollution Invntia-atlom >ln« January 1982." AAAnia to minvtes of
Florida Air Pollution Control Comminion, Lakeland, Florida, June 29. 1962,

FLORIDA HEALTH NOTES • 121

Not only Florida's tropi-
cal flora, but its clean
air are an attraction to
millions of tourists.

ologist Morris Neiburger: "All civilization will pass away, not
from a sudden cataclysm like a nuclear war, but from gradual
suffocation in its own wastes." 3

Everyone is affected by air pollution. A normal person can

Z. Borland. Theodore. "Our Dirty Skr." TodaVt Health. Vol. 44, No. 3, March 1966. pp. 40-42.

122

FLORIDA HEALTH NOTES

live on four and a half pounds of water a day; he needs two
pounds of food daily ; but he needs 30 pounds of air. Since breath-
ing is a natural bodily function, he cannot be selective about the
air he breathes as he can about the food and water he consumes.

Air pollution affects your health. Because no one can experi-
ment on humans and because everyone is exposed to polluted air,
there can be no rigid scientific proof to pinpoint the exact effects
of dirty air on our health. Specific pollutants have been found in
the blood and certain organs of people breathing dirty air. Some
of these chemicals are known to irritate the respiratory system,
to inhibit the wave-like cleansing motions of its tiny "hairs" called
cilia.

Air pollution can affect people's aesthetic tastes. It can dim
the sunshine, shut out the view of distant objects, and leave its
mark on buildings and vegetation. It can also be dangerous when
it cuts down the vision of automobile drivers and airline pilots.

The typical reactions of humans to air pollution are watering
eyes, sniffly noses, sore throats and coughs. This is how it affects
normal people. For those who have asthma, emphysema, bron-
chitis or some other chronic respiratory illness, a rise in today's
air pollution level can make these people cough, gag, pant and
suffer chest tightness.

The chances of a man between the ages of 50 and 70 dying of
such lung diseases as emphysema, bronchitis and asthma are twice
as great if he lives in an air-polluted area compared to living
in a clean-air area. 3

Air pollution also affects the financial well-being of people
by destroying land values; it dirties clothes, making laundering
and the purchasing of new clothing more necessary; it adds to
the cost of telephone and electricity because pollutants corrode
electrical contact points; it is a safety hazard because it cuts
clown on vision on the highway; and it keeps tourists away from
scenic spots hidden by smog or smoke.

3. Ibid. p. 43.

FLORIDA HEALTH NOTES • 123

Not only Florida's tropi-
cal flora, but its clean
air are an attraction to
millions of tourists.

ologist Morris Neiburger: "All civilization will pass away, not
from a sudden cataclysm like a nuclear war, but from gradual
suffocation in its own wastes." 2

Everyone is affected by air pollution. A normal person can

a, n.rtund, Th.ixJorr, "Our Dirty Sky." Toda^t Utalth, Vol. «4. No, 3, Mart* 1966. pp. 40-42.

122

FLORIDA HEALTH NOTES

live on four and a half pounds of water a day; he needs two
iounds of food daily; but he needs 30 pounds of air. Since breath-
ing is a natural bodily function, he cannot be selective about the
ur he breathes as he can about the food and water he consumes.

Air pollution affects your health. Because no one can experi-
ment on humans and because everyone is exposed to polluted air,
here can be no rigid scientific proof to pinpoint the exact effects
of dirty air on our health. Specific pollutants have been found in
the blood and certain organs of people breathing dirty air. Some
of these chemicals are known to irritate the respiratory system,
to inhibit the wave-like cleansing motions of its tiny "hairs" called
cilia.

Air pollution can affect people's aesthetic tastes. It can dim
the sunshine, shut out the view of distant objects, and leave its
mark on buildings and vegetation. It can also be dangerous when
it cuts down the vision of automobile drivers and airline pilots.

The typical reactions of humans to air pollution are watering
eyes, sniffly noses, sore throats and coughs. This is how it affects
norma] people. For those who have asthma, emphysema, bron-
chitis or some other chronic respiratory illness, a rise in today's
air pollution level can make these people cough, gag, pant and
suffer chest tightness.

The chances of a man between the ages of 50 and 70 dying of
^uch lung diseases as emphysema, bronchitis and asthma are twice
as great if he lives in an air-polluted area compared to living
in a clean-air area. 3

Air pollution also affects the financial well-being of people
hy destroying land values; it dirties clothes, making laundering
mcl the purchasing of new clothing more necessary; it adds to
he cost of telephone and electricity because pollutants corrode
■lectrieal contact points; it is a safety hazard because it cuts
lown on vision on the highway; and it keeps tourists away from
enic spots hidden by smog or smoke.

Ibid. p. IS.

FLORIDA HEALTH NOTES • 123

State Board of Health's Authorization

Why is the State Board of Health concerned about air pollu-
tion and its effect on health? This state agency is charged under
Chapter 381 of the Florida Statutes to " . . . formulate general
policies affecting the public health of the state . . . "* and "com-
mence and maintain all proper and necessary actions and proceed-
ings to enjoin and abate nuisances dangerous to the health of
persons, fish and livestock . . . " s It is charged with protecting
and preserving the public health.

The State Board of Health, furthermore, was given authority
in 1955 when the State Legislature amended Chapter 381 of Flori-
da Statutes to adopt rules and regulations necessary "to control
pollution of the air . . . where created on private property, in
public places, or in any place or manner whatsoever." 9

Florida Statutes, in Section 403.02, defines air pollution as the
"presence in the outdoor atmosphere of substances in quantities
which are injurious to human, plant or animal life, provided that
all aspects of employer-employee relationship as to health and
safety hazards are excluded, and provided further, the term air
pollution shall not be deemed to include smoke effluent from
pulp and paper mills equipped with and operating electrostatic
precipitators or other mechanical devices whereby not less than
90 per eent of the solids of such smoke are removed therefrom." 7

Chapter 386 of Florida Statutes, as revised by Chapter 63-64,
House Bill 513, 1963 Session, provides that air pollutants, gases
and noisome odors which are harmful to human or animal life —
existing, permitted, maintained, kept or caused by any individual,
municipality, organization or corporation, governmental or private,
shall constitute prima facie evidence of maintaining a nuisance
injurious to health. 8

A, Florida Statutes, Chapter 381.03 (1) (a), State of Florida, 1965. p. 1879.

5. Florida Statute*. Chapter 381.081 (4Kb) 3. State of Florida, 196S. p. 1880.

6. Florida Statutes. Chapter 831.031 (l)(g)7. State of Florida, 1965. p. 1880.

7. Florida Statutes, Chapter 403.02 (3), State of Florida, 1966. p. 1970.

8. Florida Statute*. Chapter 38G.041 {!)(«), State of Florida, 1966. p. 1002.

124 • FLORIDA HEALTH NOTES

The definition of air pollution in the law, both expressed and
implied, restricts matters to be dealt with by the State Board
of Health to those situations in which pollution is injurious or
could reasonably be expected to become injurious to human, plant
or animal life. There is no question that such pollution should be
eliminated. In some instances such pollution does occur, but in
many cases this is very difficult and costly to prove. Some of
these conditions develop over a long period of time and by the
time they are identified, the damage has been done. There are
adverse effects of air pollution which do not come within the
definition of the law. These include reduced visibility, soil and
corrosion of materials, deterioration of real estate value, and
diminished attractiveness of an area for recreational purposes.

The myriad of complaints received by the State Board of
Health demonstrates that effects of air pollution, other than
health impairment, are of concern to residents of the state. Even
where a sound legal basis for pollution control is lacking, the
State Board of Health works toward solving these problems by
providing technical information and consultation services to those
affected. Reasonable working relationships have been established
with the phosphate, power and asphalt industries and other sourc-
es of air pollution throughout the state. These relationships allow
for a mutual understanding of the technical and administrative
problems of pollution control.

This issue of Florida Health Notes will tell you what the State
Board of Health and County Health Departments are doing about
air pollution problems and what they need to enlarge the programs
already in existence or create new ones in areas where problems
occur.

What is Air Pollution?

As long as there has been air on this earth, there has been
air pollution. There is no such thing as "pure air." Purity of the
air is a matter of degree and it can fluctuate with current move-

FLORIDA HEALTH NOTES • 125

ment and speed. Air in some locations is freer of pollutants at
certain times than air in other locations at the same time.

Areas far from cities and civilization have polluted air. Nature
pollutes the atmosphere with sand and dust storms, forest fires
and volcanic eruptions. Living and dying things emit pollution.
The terpenes given off by forests create the haze that gives the
Blue Ridge and Smoky Mountains their names. Flowers give off
pollen and decaying matter gives off gases.

Pollution in nature is minor compared to what man has given
off under the guise of civilization. Man spews tons of noxious
gases and dirt into the atmosphere every day. In the United
States alone, 133 million tons of waste flow upward annually
through the skyward sewer.

You can see part of this waste matter. The smoke is made
up of tiny particles of carbon and ash as well as microscopic
particles of metal filings, lead, oil and grease. Water vapor may
be given off as steam but this is dissipated as water.

Not all air pollution can be seen. The invisible gases that pol-
lute the air include the dangerous oxides such as sulfur dioxide,
nitrogen dioxide and carbon monoxide. There are also hydrogen
sulfide and ozone and with the exception of carbon monoxide
which is odorless, all are detected by one of the most sensitive
chemical detectors of all — your nose.'

Sources of Pollution

Where do all of these pollutants come from? An automobile
takes a ton of air for every tank of gas it burns, but in turn it
releases three pounds of carbon monoxide, plus lesser amounts of
hydrocarbons, nitrogen oxides, aldehydes, ammonia, lead organic
acids, sulfur compounds and metallic oxides. In colder climates,
coal discharges black smoke and 48,000 tons of sulfur dioxide every
day from home heating and industrial plants. 10

9. Op. fit. Borland, Theodore, p. 43.

10. Ibtd. p. 43.

126 • FLORIDA HEALTH NOTES

As in other states, sources of pollution in Florida include
chemical plants, electric power generating stations for municipal-
ities and institutions, home heating plants, trash burners, asphalt
plants, incinerators and pulp and paper mills. In the cooler seasons,
Florida's orange-growing areas are blanketed with black smoke
from citrus smudge pots burned to protect citrus trees from the
cold.

What happens to this pollution? We live at the bottom of a sea
of air. It is usually warmest at ground level. The air above is
much cooler, normally dropping about five degrees Fahrenheit
in temperature for every thousand feet of altitude. At 30,000
feet, usually the height for jet airliners, the temperature outside
the planes is a minus 50 degrees.

Air pollutants normally rise through the cold layers of air
simply because they are lighter and warmer, like oil rising to the
top of a glass of water. Sometimes a layer of warmer air, several
thousand feet up, may keep the rising air and its pollutants from
rising any further. This is how a temperature inversion (a high
layer of air which is warmer than lower air) acts as a lid." Some-
times a similar type of inversion occurs at ground level.

Florida has some Air Pollution Problems

While Florida does have some air pollution problems in various
geographical locations, its municipalities do not have the exper-
iences of such cities as Los Angeles, New York, Chicago or Lon-
don. Florida does not have such terrain as the mountains of Cali-
fornia or narrow industrial valleys of the North where air pollu-
tion is a well-known problem. Climate is Florida's greatest asset
in many ways. The state does not have the long winters and the
considerable pollution from fuel consumed by long operation of
heating systems. Winds which cross the state usually move at a
rate of speed that eliminates much of the pollution. When a high
pressure system does settle down over an area for several days,
the stable air may act as a "lid" which does not allow the up-
ward dispersion of pollution.

H. /bid. p. 44.

FLORIDA HEALTH NOTES • 127

Industrial cities, such as London, Pittsburgh and St. Louis
have fought and conquered smogs of sulfur dioxide and water
vapor. Los Angeles has found itself battling a smog composed,
not so much of smoke, but of gases, including gasoline vapor,
nitrogen dioxide, ozone and peroxyacetyl nitrate. When combined
with the fumes from such a tremendous number of automobiles
(1300 cars per square mile), the photochemical smog is over-
whelming,

Chicago, with an average of 40 days of temperature inversions
a year, has more automobiles per square mile than Los Angeles,

128

FLORIDA HEALTH NOTES

plus pollution from steel mills and industries. New York City
has battled apartment building incinerators, commercial incinerat-
ors and millions of automobiles and thousands of diesel buses
and trucks, 13

Florida's three largest cities, Miami, Jacksonville and Tampa,
have gasoline consumption exceeding the amounts associated with
photochemical smog in other cities. Even though the state has
an abundance of sunshine, one of the factors involved in making

12. Ibid. pp. 43-44.

tea

tt

Jacksonville is blanketed by
an early morning smog caus-
ed by a temperature in-
version. Such inversions oc-
cur mostly in the cooler
months.

FLORIDA HEALTH NOTES

129

■fe.

Industrial cities, such as London, Pittsburgh and St. Louis
have fought and conquered smogs of sulfur dioxide and water
vapor. Los Angeles has found itself battling a smog composed,
not so much of smoke, but of gases, including gasoline vapor,
nitrogen dioxide, ozone and peroxy acetyl nitrate. When combined
with the fumes from such a tremendous number of automobiles
(1300 cars per square mile), the photochemical smog is over-
whelming.

Chicago, with an average of 40 days of temperatui'e inversions
a year, has more automobiles per square mile than Los Angeles,

128

FLORIDA HEALTH NOTES

■

plus pollution from steel mills and industries. New York City
has battled apartment building incinerators, commercial incinerat-
ors and millions of automobiles and thousands of diesel buses
and trucks. 12

Florida's three largest cities, Miami, Jacksonville and Tampa,
have gasoline consumption exceeding the amounts associated with
photochemical smog in other cities. Even though the state has
an abundance of sunshine, one of the factors involved in making

12. Ibid. pp. (3-44.

Jacksonville is blanketed by
an early morning smog caus-
ed by a temperature in-
version. Such inversions oc-
cur mostly in the cooler
months.

FLORIDA HEALTH NOTES

129

1

photochemical smog, favorable trade winds and rare occurrences
of daytime inversions restrict the appearance of smog to a few
times a year. 13

Because the automobile is an important contributor to air
pollution, the staff of the State Board of Health at one time con-
sidered recommending the attempt to have statewide regulations
or laws passed in Florida restricting the emissions of exhaust
fumes from automobiles. However, it was felt that such state-
wide controls would be ineffective unless there were similar con-
trols elsewhere in the country. In some areas of the state there
are nearly as many out-of-state cars at certain seasons of the
year as local automobiles registered in Florida. Therefore, the
proposed laws were discarded because they would have penalized
Florida motorists and allowed out-of-state motorists to go free.
The State Board of Health has supported nationwide rules be-
cause these were the only practical approach to the control of air
pollution from automobiles. 14

While Florida has climate, temperature and terrain that helps
prevent air pollution, the geographic distribution of population
and manufacturing could lead to air pollution problems. The 11
most populous counties have 70 per cent of the population and
75 per cent of the manufacturing. About a third of the paper
industry, three-fourths of the chemical manufacturing and food
processing and all but two of the phosphate plants are located
in these counties.

Many leaders in the state are actively seeking to develop new
industry but few, if any, would jeopardize the $3 billion tourist
industry which the state enjoys. Many tourists spend much of
the cooler season along the lower east and west coasts and com-
munities in these regions are skeptical of any activity which
might lower the tourist desirability of these areas. Some com-
munities are so concerned with the possibility of industries that
are heavy users of fuels which cause smoke, that civic leaders

13. Harding, C. I., Mi-K«, S. B. and Sehueneman, J. J. Florida's Air Resource*. Florida
State Board of Health. Jacksonville, Florida, 1961. p. 37.

U. Patton, Vincent D. "Florida's Air Pollution," paper presented before Florida Chapter
American Public Works Association. Sixth Annual Convention. Tampa. Florida, May 5, 1966.

130 • FLORIDA HEALTH NOTES

Phosphate fertilizer
plants, such as this one,
emit fluorides and other
gases into the air. Limits
have been set by the
Florida Air Pollution Con-
trol Commission and the
State Board of Health as
to how much fluoride can
be released by each plant.

actively discourage industry from settling in areas that are de-
voted primarily to tourism. 15

A Major Problem — The Phosphate Industry

While Florida has some areas with minor air pollution prob-
lems, a major cause of concern has been the 500 square mile area
in Polk and Hillsborough Counties that is the phosphate "coun-
try." Approximately 75 per cent of the nation's supply of phos-
phate, and one-third of the world's supply, is mined in this area.
In 1959, 11.5 million long tons, valued at $71.6 million, were
mined. By 1965, mine production had increased to 18.2 million
long tons worth $131 million.

IB- Op. Cit. Hwdlnz, C. I., McKee. S. B. and SehirnietMH. J. J. p. 21.

FLORIDA HEALTH NOTES

131

This is an industry which developed essentially from only pro-
duction of ore to the complex chemical processing industry known
today. Early manufacturing produced what is known as "single
strength superphosphate" until the end of World War II, when
triple superphosphate, a more concentrated form, began to be
produced. With this increased processing, there resulted a con-
siderable evolution of fluoride, in various forms, which is tied up
in phosphate ore. 19

The rock is primarily a fluorapatite and practically insoluble
in water. The fluoride must be removed before the phosphate can
be made soluble and available as plant food. Due to the high
freight rates for shipping raw rock, great emphasis has been
placed on processing the rock in Florida into high-analysis phos-
phate compound for shipment to other parts of the country.

In removing the fluoride from the rock, gases are emitted into
the atmosphere and absorbed by vegetation, such as grasses, citrus
and gladioli in the Polk-Hillsborough area. It is the opinion of
some people that when cattle eat contaminated forage, excessive
amounts of fluoride can cause the gums and teeth of the cattle
to become spongy, the teeth to fall out or wear away. There
is an overgrowth of bones. Milk production and the reproductive
process of cattle are affected.

It is claimed by some people that the effects of the fluoride
absorption by citrus trees vary from minor reduction of crops
to complete defoliating of trees and dropping of fruit. Approxi-
mately 25 per cent of the state's citrus crop is grown in Polk
County so this condition could have an effect on the economic life
of the area. Large areas of Hillsborough County are devoted to
gladioli culture. These flowers are one of the plants most sensitive
to fluorides and during adverse weather conditions, whole fields
are said to have been "burned" in a short time by the fluorine
containing gases. 17

It. Op. Cit. Pattern. Vincent D.

IT. Op. Cit, Harding, C. I.. MeKn, S. B., and Schueneman, J. J. pp. 24-26.

132 • FLORIDA HEALTH NOTES

Although the bulk of phosphate mining and processing is lo-
cated in Polk and Hillsborough Counties, considerable deposits of
phosphate rock have been found in other areas of the state. Large
mining and processing complexes have been constructed in Hamil-
ton and Manatee Counties and have started operations.

The Florida Air Pollution Control Commission

Florida took action on its air pollution problems in 1955 when
Chapter 381 of Florida Statutes was revised, assigning to the
State Board of Health the authority to promulgate rules and
regulations for the control of air pollution. However, prior to and
during this period local health departments did spend considerable
time on minor air pollution problems associated with public health
nuisance abatement activities. In 1957, the State Legislature
adopted the Florida Air Pollution Control Law, Chapter 403 of
Florida Statutes, which provided for an Air Pollution Control
Commission within the State Board of Health.

For two years after the Air Pollution Control Law was passed
air pollution control was under the State Board of Health's Bureau
of Preventable Diseases but in July 1959 the Bureau of Sanitary
Engineering took over the work. The majority of the activities
has centered in the Polk-Hillsborough Air Pollution Control Dis-
trict which has its headquarters in the State Board of Health's
Winter Haven Laboratory. The Winter Haven group is charged
with the responsibility of enforcing rules and regulations of the
Florida Air Pollution Control Commission and conducting other
work, such as air sampling surveys in other counties, which per-
tain to air pollution control. In addition, one sanitary engineer
has been assigned to investigate air pollution throughout the state
and to secure abatement of air pollution sanitary nuisances.

A new "permit system" was established within the District by
the Commission on January 20, 1965, whereby permits covering
fluoride emissions are granted for construction, limited operation
and operation of phosphate processing and chemical plants. 18

19. Florida Adminittrative Cod*. Rules of the Florida Air Pollution Control Commission,
28-4.02. p. 11.

FLORIDA HEALTH NOTES • 133

Activities of the Air Pollution Control District

The programs of the Polk-Hillsborough Air Pollution Control
District vary and include:

Monitoring grasses, filter papers, pasture grass samples and
gladioli; in-plant inspections; source air sampling; and plan re-
view and special projects for specific air problems.

The grass monitoring program, discontinued about a year ago,
had involved six Pensacola Bahia grass stations located on a one-
mile radius around each phosphate plant. Grass was sampled
monthly and analyzed for fluoride content. At each of these
Bahia grass sites, chemically treated filter papers were also ex-
posed for four weeks and then analyzed. The results provided an
indication of the fluoride extracted from the air. Pasture grass
sampling was given greater emphasis in 1964 and currently sam-
ples are collected from 54 stations. Graphic presentation of these
samples indicate changes in fluoride concentrations for specific
time periods.

Gladiolus leaf and ambient air samples are collected and tested
during the gladiolus growing season.

Since May X, 1963, 103 approvals have been granted to ferti-
lizer manufacturers for the installation of devices to control the
emission of fluorides and dusts within the District. Such control
devices remove most of the fluorides generated by the fertilizer
industry.

In-plant inspections, source samplings and plan reviews are
conducted by the Winter Haven staff to implement the approval
of plans and issuing of permits which are called for in the rules
of the Mori da Air Pollution Control Commission.

Under the "permit system" no person can construct any new
installation or plant without first submitting the plans and
specifications to the State Board of Health for its review and
approval and obtaining a permit to construct. When approval is
granted by the State Board of Health, a maximum allowable daily
emission of fluorides is set and a permit to construct is issued
accordingly.

134 • FLORIDA HEALTH NOTES

Following construction of the installation or plant, an inspec-
tion is made by the State Board of Health personnel to determine
whether the conditions of the permit to construct have been met.
If it is found that the installation or plant conforms to the law,
the State Board of Health issues a limited permit to operate,
which is effective for a period of six months. During the six-
month period tests are performed by the State Board of Health
personnel to determine compliance with the maximum allowable
daily emission set forth by the state agency. If compliance is
evident a permit to operate is issued.

A total of 58 permits have been issued by the State Board of
Health. Of these, 27 have been permits to construct, 27 have been
limited permits to operate, and four have been permits to operate.
As of September 1966, one other plant was reported eligible to
receive a permit to operate and three others were ready to be
tested.

In addition to the above projects, several special studies have
been performed by personnel of the Bureau of Sanitary Engineer-
ing. Noteworthy among these were a detailed study of the extent
of air pollution within the city limits of Bartow, a study of the

Some Accomplishments

"Unquestionably, the state program and activities in the Polk-
Hillsborough District have effectively reduced air pollution emissions
in this area. This has been accomplished even though there has
been a tremendous expansion of the phosphate rock processing in-
dustry within the last eight years. It is generally agreed, however,
that the air pollution problems are not completely resolved and much
additional effort is needed. The Florida State Board of Health is
fortunate in having on its staff engineers who are nationally recog-
nized for their expertness in the field of air pollution control from
phosphate rock processing operations."

Howard W. Chapman
Associate Regional Health Director
for Environmental Health Services
(in letter to Wilson T. Sowder, M.D.
State Health Officer)

FLORIDA HEALTH NOTES

135

atmospheric concentrations of the sulfur dioxide acid aerosol in
Polk-Hillsborough Counties, suspended particulate determinations
in the vicinity of a fertilizer plant at Fort Pierce and investiga-
tion of the effect of ambient air fluoride concentrations on citrus
leaf.

Also the Winter Haven staff has assisted the consultant engi-
neer of the central office in the numerous investigations of com-
plaints, sampling studies and presentation of courses.

At the present time, there ia only one air pollution control
district in the state. It is the only one that has been requested
by the people of Florida. The Air Pollution Control Commission
may organize and create or dissolve air pollution control districts
within the state following a public hearing. A hearing may be
held by the Commission under any one of the following three con-
ditions: upon petition from the board of county commissioners of
one, two or more counties ; upon petition signed by 15 per cent
of a county's freeholders; or upon petition by the State Board of
Health after investigations show the necessity for such a district.

Enforcement of Rules and Regulations

The law gives the State Board of Health the power to investi-
gate complaints of air pollution. If after investigation the com-
plaints are justified and the pollution continues beyond the
emission limits, the State Board of Health, through conferences,
conciliation and persuasion, as required by law, can request the
offending company to eliminate the pollution. 19

If the situation is not corrected within 60 days following the
filing of the complaint, the State Board of Health can notify the
company that it is being brought before the Air Pollution Control
Commission for a hearing. If the Commission agrees with the
State Board of Health that pollutants are being released into the
air, the company is given a reasonable amount of time to remedy
the situation. Should the company fail to apply preventive or
corrective measures within the specified time, an injunction can
be sought in the courts. If a trial is held, the company can be

19. Florida Statute*. Chapter 403.13 and 403. U. State of Florida, 1965, p. 1972.

136 • FLORIDA HEALTH NOTES

charged with a misdemeanor and given a small fine or an officer
of the company can be given a short jail sentence. 3 * Persons whose
interests are affected by the ruling of the Commission can petition
for a rehearing before the Commission within 30 days or ask for
a judicial ruling on the actions of the Commission.

While there presently is no known method of establishing a
100 per cent control of fluorides and sulphur dioxides, strict
emission quotas are regularly imposed on phosphate operations to

20. "Air Pollution" Florida Health Not**. Florid* State Board of Health. Jacksonville. Florida,
Vol. ST, No. 1, January 1965. p. IS.

Fumes from a phosphate fertilizer plant cannot be seen because they
are tunneled through this "scrubber" which washes the air before it is
released into the atmosphere. The phosphate industry has spent millions
of dollars on research and installation of such air pollution control de-
vices.

atmospheric concentrations of the sulfur dioxide acid aerosol in
Polk-Hillsborough Counties, suspended particulate determinations
in the vicinity of a fertilizer plant at Fort Pierce and investiga-
tion of the effect of ambient air fluoride concentrations on citrus
leaf.

Also the Winter Haven staff has assisted the consultant engi-
neer of the central office in the numerous investigations of com-
plaints, sampling studies and presentation of courses.

At the present time, there is only one air pollution control
district in the state. It is the only one that has been requested
by the people of Florida. The Air Pollution Control Commission
may organize and create or dissolve air pollution control districts
within the state following a public hearing. A hearing may be
held by the Commission under any one of the following three con-
ditions: upon petition from the board of county commissioners of
one, two or more counties; upon petition signed by 15 per cent
of a county's freeholders; or upon petition by the State Board of
Health after investigations show the necessity for such a district.

Enforcement of Rules and Regulations

The law gives the State Board of Health the power to investi-
gate complaints of air pollution. If after investigation the com-
plaints are justified and the pollution continues beyond the
emission limits, the State Board of Health, through conferences,
conciliation and persuasion, as required by law, can request the
offending company to eliminate the pollution. 1 "

If the situation is not corrected within 60 days following the
filing of the complaint, the State Board of Health can notify the
company that it is being brought before the Air Pollution Control
Commission for a hearing. If the Commission agrees with the
State Board of Health that pollutants are being released into the
air, the company is given a reasonable amount of time to remedy
the situation. Should the company fail to apply preventive or
corrective measures within the specified time, an injunction can
be sought in the courts. If a trial is held, the company can be

19, Florida Ulatuies, Chapter 503.13 and 403.14, State of Fiuriila. 1965. p. 1912.

136 • FLORIDA HEALTH NOTES

charged with a misdemeanor and given a small fine or an officer
of the company can be given ft short jail sentence. 2 " Persons whose
interests are affected by the ruling of the Commission can petition
for a rehearing before the Commission within 30 days or ask for
a judicial ruling on the actions of the Commission.

While there presently is no known method of establishing a
100 per cent control of fluorides and sulphur dioxides, strict
emission quotas are regularly imposed on phosphate operations to

20. "Air Pollution" Florida Health Noltt. Florida State Board of Health. JackionviU*, Floruia.
Vol. ST. No. 1, January 1S6S. p. 16.

Fumes from o phosphate fertilizer plant cannot be seen because they
are tunneled through this "scrubber" which washes the air before ir is
released into the atmosphere. The phosphate industry has spent millions
of dollars on research and installation of such air pollution control de-

vices.

control fluoride emissions. Giant strides have been made, especial-
ly since 1960, with the fluoride emissions in the Polk-Hillsborough
area dropping from 33,000 pounds to 13,000 pounds per day in
1965. 21 Many of the phosphate companies have installed scrubbers
and other devices at the insistence of the State Board of Health.
One problem remaining is the pollution from the huge drying
sheds where the phosphate rock is allowed to "cure." In the
process of curing, the rock gives off fluorides into the air.

Agricultural and Phosphate Interests

Air pollution has spurred open resentment between agricultural
and phosphate interests and aroused demands that the State Board
of Health curb emissions of fluorine and sulphur dioxides, plus
other gases and particulates, from phosphate plants. There is no
argument that pollution does exist and such pollutants are emitted
from phosphate operations in such quantities and in sustaining
amounts to damage crops and livestock and injure health.

The question to be solved by scientists is: In what quantities
and for what periods of time must the pollutants be in existence
to result in damage? Other variables, such as atmospheric condi-
tions, wind direction and distance between phosphate operations
and agricultural areas also bear heavily on the question.

Dusts, sulphur dioxide, sulphur trioxide, sulphuric acid mist
and fluoride from the phosphate plants have been determined the
general cause of air pollution in the Polk-Hillsborough Air Pollu-
tion Control District. These are the pollutants the State Board
of Health is attempting to curb.

Under the 1965 regulations, emission levels for existing plants
within the districts were established at .6 of a pound of fluorides
per production ton of phosphorus pentoxide or chemical equivalent
per day. New plants to be designed will be equipped to comply
with a maximum emission level of .4 pounds of fluorides per ton
of manufactured phosphorus pentoxide or its equivalent per day. 22

21. Harmon, Joe, "Officiata Look to Science for Air pollution Solution." Tampa Trio***.
July 10, IMC.

22. Florida AdminiMlrativr Coat. Rule* of the Florida Air Pollution Control Commiasion.
28.3.03 (1) and BB-3.04 (2), pp. 7-8.

138 • FLORIDA HEALTH NOTES

The grass samples taken by field survey teams from the State
Board of Health laboratory showed the concentration of fluorides
in a test area and the plotting of concentrations gave a reading
of the pollution configuration of an area. Ambient air samples
were used to establish the presence of airborne fluorides and
the pollution patterns in the test area. A comprehensive analysis
of the fluoride in any given area is virtually impossible but field
teams are able to capture samples of ambient air in a specially-
designed apparatus and measure the concentrations of fluorides
at different times of the day.

This is an "exact" science within a fine tolerance and the
task of measuring samples of air throughout the two-county area
is so immense that chemists and engineers have found it imprac-
tical to use the fluoride content of air as a standard of pollution.
Concentrations of sulphur oxides are measured and established by
the use of equipment housed in mobile units. 23

Statewide Pollution Control Activities

It is the policy of the State Board of Health to promote local
control activities. However, some direct contact is practiced by
the state agency in securing abatement of air pollution problems
and in reviewing and approving plants for construction.

Outside the Polk-Hillsborough District, the activities of the
State Board of Health include the work of staff members in
Jacksonville and regional offices and indirectly all County Health
Departments. Overall policy is established by the State Board of
Health and is promulgated in various regulations contained in
the Florida Administrative Code. Notices requiring corrective
action are issued in the name of the State Health Officer.

The statewide air pollution control program consists primarily
of giving technical assistance to city and county air pollution
control operations and the conducting of special technical investi-
gations which are beyond the capabilities of local agencies.

23. Op. Cit. Harmon, Joe.

FLORIDA HEALTH NOTES • 139

Complaint investigation usually involves a visit to the person
making the complaint, an investigation of the sources of possible
air pollution, if known, and attempts through conferences, con-
ciliation and persuasion to arrive at a solution.

In many cases it is necessary to conduct source testing to de-
termine whether an operation is being carried out contrary to
good engineering practices. One such investigation involved the
fixing of the quantity of particulate material being discharged
from an asphalt plant. It was determined that emissions were
considerably in excess of those from similar plants where control
devices were employed. Because no substantiating medical evi-
dence could be obtained, and in the absence of specific standards,

Cattlemen claim that pastures
and cattle 'above! have been
damaged by pollutants emitted
by phosphate complexes, such
as the one at right. Zoning
is perhaps one answer to this
problem but the State Board
of Health has no jurisdiction
in this field.

'T

*

it was determined by the State Board of Health attorney that no
legal corrective action could be taken.

Realistic standards for asphalt plant emissions were set forth
in a revised chapter of the Florida Administrative Code in October
1965. 24 These standards, based on a series of tests carried out in
cooperation with the Asphalt Contractors Association, gave spe-
cific limitations on the quantity of particulate material which
could be emitted from asphalt operations. Ten plants were sampled
by the State Board of Health staff and an ambient air sampling
study was also conducted in the vicinity of one plant.

U, Florida Administrative Coda. The Sanitary Code of Florida. Chapter lTc-9.06 (1) lb), p. 1(1,

l r

Jpj*

Complaint investigation usually involves a visit to the person
making the complaint, an investigation of the sources of possible
air pollution, if known, and attempts through conferences, con-
ciliation and persuasion to arrive at a solution.

In many cases it is necessary to conduct source testing to de-
termine whether an o|)eration is being carried out contrary to
good engineering practices. One such investigation involved the
fixing of the quantity of particulate material being discharged
from an asphalt plant. It was determined that emissions were
considerably in excess of those from similar plants where control
devices were employed. Because no substantiating medical evi-
dence could be obtained, and in the absence of specific standards,

Cattlemen claim that pastures
and cattle (above) hove been
damaged by pollutants emitted
by phosphate complexes, such
as the one at right. Zoning
is perhaps one answer to this
problem but the State Board
of Health has no jurisdiction
in this field.

it was determined by the State Board of Health attorney that no
legal corrective action could be taken.

Realistic standards for asphalt plant emissions were set forth
in a revised chapter of the Florida Administrative Code in October
1965. 1 ' 4 These standards, based on a series of tests carried out in
cooperation with the Asphalt Contractors Association, pave spe-
cific limitations on the quantity of particulate material which
could he emitted from asphalt operations. Ten plants were sampled
by the State Board of Health staff and an ambient air sampling
study was also conducted in the vicinity of one plant.

14. Florida Adminiitrative CvtU. The Sanitary Code of Florida, Chapter lTc-9.0fl in (b). p. lot.

k r

w ¥•*•

Incinerator emission standards were based on surveys of both
municipal and package-type units. Three municipal plants and
several small package-type incinerators were tested by the State
Board of Health people and one municipal plant was sampled by
a private firm at the request of the state agency.

A current program is underway to characterize the quantity
and quality of air pollution emissions from citrus peel dryers.
There are approximately 30 such peel dryers in Florida. All have
been visited and six have been tested. Much of this work has
been directed toward selection of the proper procedure for the
collection of peel dryer emission, the best organic solution to use
as a collection medium and the proper sample preparation and
chromatographic column for final analysis. An outgrowth of this
preliminary work has been the development of a cooperative study
to be conducted at the Lake Alfred Citrus Experiment Station.
The station personnel will operate their pilot plant peel dryer
and several tests will be conducted during variations of several
controlled conditions.

In addition to sampling and testing activities, the Bureau of
Sanitary Engineering of the State Board of Health has completed
detailed surveys in Hillsborough, Alachua, Pinellas and Manatee
Counties. Based on these data the bureau has made recommenda-
tions related to the counties' air pollution control programs which
should be implemented. Similar studies in Broward and Escambia
Counties are in progress.

The State Board of Health, with the U. S. Public Health
Service, participated in a pilot study of air pollution conditions
in Jacksonville. The objectives of the pilot study were to develop
a preliminary opinion as to whether the City of Jacksonville has
a generalized air pollution problem and to determine whether
fluorides and sulfur dioxides were present in the atmosphere in
concentrations capable of producing the damage to vegetation
which has been experienced in Jacksonville-Duval County area. 25

to. Sheeny. 1. P.. et al. "A Pilot Studj of Air Pollution in Jacksonville, Florid*." D. S.
Department of Health, Education, and Welfare. Public Health Service, Division of Air
Pollution, April 1S63.

142 • FLORIDA HEALTH NOTES

Also in cooperation with the U. S. Public Health Service and
the Dade County Department of Public Health, a report on the
management of Dade County's air resources was prepared.

Liaison has also been established with the pulp and paper
industry> This industry can certainly be classed as one of the
industrial giants in Florida. Primarily, these mills are located
across the northern part of the state. They are characterized by
their enormous size and insatiable consumption of pulp wood and
the production of certain waste products. One of the economic
features of the "Kraft" process, which the majority of these mills
use, is the ability to recover and reuse chemicals which could
otherwise be added to the atmosphere. As a result, this economic
impetus has resulted in several recovery devices being installed
which also reduce the pollution emissions. However, it is extremely
difficult to build such a device so that it will be 100 per cent
efficient. As a result, there is some loss of particulate matter
into the atmosphere. To further complicate the picture, sulfur-
containing compounds are used in the Kraft process and the human
nose is very sensitive to some of these materials, even in very
low concentrations. 28

The power industry is another industrial giant in Florida. There
are problems of emissions of particulate matter and sulfur com-
pounds in this industry also. The State Board of Health has been
concerned with several power plants using Bunker C oil which,
when burned, gives off particulate matter as well as sulfur dioxide
and acid mist.

One power plant has been tested in an effort to relate sulfur-
oxide emissions to varying oil-natural gas rations at different
values of excess air. Because the natural gas supply is limited,
i he State Board of Health has taken an active part in proceedings
before the Federal Power Commission to secure additional amounts
>f natural gas for the state. It was anticipated that the additional
upply of natural gas for use by power plants would help eliminate
omplaints relative to the operation of generating stations, par-
icularly in urban areas where fuels of high sulfur content are

Op. Cit, Pitton. Vineent D.

FLORIDA HEALTH NOTES

143

burned. It appears that this application has been denied for a
number of reasons. One of the jobs of the Federal Power Com-
mission is to conserve the nation's natural resources.

Another power plant is currently expanding its generating
capacity and installing air pollution control equipment which is
far more efficient than that installed on the original construction.
This is a direct result of the revision of Chapter 170C-9 of the
Florida Administrative Code. 27

As previously mentioned, phosphate processing is now becoming
significant in areas outside of Polk and Hillsborough Counties.
New facilities in Hamilton and Manatee Counties have been re-
viewed by the State Board of Health and assurance has been given
by the companies that the most up-to-date air pollution control
devices will be utilized at these plants.

Air Pollution is a Health Problem

There is little doubt that air pollution is at the very least a
contributing factor to the rising incidence of chronic respiratory
diseases, lung cancer, emphysema, chronic bronchitis and asthma.
There is some evidence to suggest that certain types of air pol-
lution may even contribute to those upper respiratory diseases
known as the "common cold." 28

"It is recognized that at 1000 parts of carbon monoxide per mil-
lion parts of air, the gas kills quickly. At 100 parts it produces
bad headaches and dizziness. At present, 50 parts is considered
the danger point. But as we learn more we are less sure. Cali-
fornia found that 30 parts per million for eight hours seriously
affects people who already have poor blood circulation. Since
monoxide sickens and kills by capturing the oxygen carriers in the
blood, people with heart disease, arteriosclerosis, asthma or
emphysema, as well as heavy smokers, are unusually vulnerable." 28

2T. Florida A dminUt native Code. The Sanitary Code of Florida. Chapter 170c-9. p. 101.

28. Stewart, William H. "Air Pollution — Time for Action." Paper presented at the 59th
annual meeting of the Air Pollution Control Association, San Francisco, Calif., June 20. 1966.

29. BaRdikian. Ben H. "Death In Our Air" The Saturday Evening Pott. October B. 1966.
p. 106.

144 • FLORIDA HEALTH NOTES

The number of people succumbing to lung ailment is doubling
every five years. Some medical studies have found an association
between polluted air and lung cancer. But determination of the
cause of this killer is complicated by the contribution of cigarette
smoking as well as many other factors, such as infection, viral
agents and genetic predisposition. 30

The State Board of Health identifies air pollution as a public
health hazard. It encourages and will investigate legitimate com-
plaints from citizens of Florida whose health is or has been af-
fected by pollutants.

In 1966, a petition with approximately 4000 names was re-
ceived by the State Board of Health and Florida Air Pollution
Control Commission from temporary and permanent residents of
the Polk-Hillsborough Air Pollution Control District.

The petition noted a "serious menace" and asked that as "ex-
perts on air pollution and charged with the responsibility under
the laws of this State of Florida to control it," the State Board
of Health and Commission take steps to abate the problem. The
State Board of Health set out to determine the extent to which
air pollutants had damaged the health or impaired the comfort
of individuals signing the petition. Inquiries were sent to 1000
names on the petition whose addresses could be ascertained. A
second mailing was made, which was followed up by visits to
permanent residents who had failed to respond to the second
communication.

The results of the survey showed that 8.8 per cent had com-
plaints of health effects; 5.9 per cent complained of annoyance
or irritations; and 50.4 per cent had no complaints. The balance,
34,9 per cent, were either winter guests or temporary residents;
had not signed the petition ; promised information by mail ; re-
fused information; or had died. 81

SO. Op. Cit. Borland, Tbeodore-

31. Appendix A. The Health Effect* of Air Pollution in Potk County.

FLORIDA HEALTH NOTES

145

Eleven physicians who had been consulted by some of the
petitioners were contacted by the State Board of Health. Some
physicians were convinced that air pollution was a significant con-
tributor to the complaints of some of their patients while other
physicians did not attribute symptoms to this cause.

Some petitioners named specific plants as contributing to their
discomfort. Complaints which related to the industry as a whole
signified eye or respiratory tract symptoms. Complainants men-
tioned burning of the eyes, irritation of the nose and throat and
excessive coughing. Symptoms of an asthmatic nature or sinus
trouble and post-nasal drip were repeatedly mentioned and episodes
of nose bleeding were also reported, particularly in one school.

The State Board of Health participated in two studies and the
data showed that there was no significant evidence of either harm-
ful or beneficial effects of fluorides due to air pollution in Polk
County.

The problems of the effects of air pollution on health is of
concern to the State Board of Health. The maintenance of an
environment conducive to good health is one of the reasons the
Board is seeking more rapid control of air pollution in the Polk-
Hillsborough area, as well as other areas of Florida with similar
problems.

The State Health Officer has directed that continuing studies
into the effects of air pollution be planned and has given as-
surance that appropriate field assistance can be made available. 82

Help for the People

Because air pollution does not stop at state lines, the U. S.
Congress passed the Clean Air Act of 1963. The act with the
amendments of 1965 includes strengthened research and techni-
cal assistance activities; a match ing-grant program which offers
substantial financial stimulation for the creation of improved
state and local regulatory agencies ; a Federal abatement program

12. Ibid.

146 • FLORIDA HEALTH NOTES

Phosphate rock, which is
shipped from Florida
throughout the world, is
loaded aboard a ship at
Tampa. Workers aboard
the ship are required to
wear masks to avoid
breathing in pollutants.

focused primarily on interstate problems; and national regulations,
relative to automobile exhaust emissions.

The Surgeon General of the U. S. Public Health Service has
stated, ". . . the primary thrust of Federal air pollution legislation
is to help states and local governments improve their efforts to
control air pollution. There is no doubt in my mind that it was
the intent of Congress to accelerate the development and im-
provement of strong state and local regulatory control programs,
strong enough and independent enough to stand up to those from
industry or government who are always ready to say, 'Yes, this
is a serious problem, but let's take care of it next year or the year
after that."

"Totally, including both Federal and non-Federal contributions,
the funds available for state and local air pollution programs have
increased by about 65 per cent since the adoption of the Clean Air

FLORIDA HEALTH NOTES

147

Act. Some $20 million is now being- invested annually in state
and local programs — about $5 million at the state level and about
$15 million at the local level. While these amounts are far from
adequate they do compare favorably with the combined state and
local spending of about $12.7 million at the end of 1963.

"Of the agencies that have received Federal grants under the
Clean Air Act, 52 are developing new programs. About 18 are
establishing programs which had already been legally authorized
but not activated. In addition, 40 agencies have received grants
to assist in the improvement of existing programs.

"The number of state programs in being or under development
has reached 33, compared to 17 in 1961. In the same period, the
number of local programs in operation has increased from 85 to
130.

"While the response of states and local agencies has been en-
couraging, we have really only begun to make a beginning. Most
cities and states are still without the services of effective control
programs. There are now 33 state air pollution programs, but
many of these are scarcely more than nominal. They have neither
the authority nor the resources to carry on effective control activi-
ties. Only a half-dozen engage in more than a minimal degree of
actual abatement activity, few are serving those communities
which are too small to operate their own local programs.

"Efforts at the local level are equally deficient. Our most
recent estimate indicates that only 50 per cent of the urban popu-
lation of the United States is served by local air pollution pro-
grams. Where they do exist, they commonly do not have adequate
resources. On a per capita basis, annual spending for local pro-
grams has increased in recent years from a medial figure of 10.8
cents to 15.2 cents. This increase is hardly adequate in the light
of estimates that an effective local control program for a middle-
size city requires an expenditure of at least 40 cents per capita
per year." 33

33. Op. Cit. Stewart. William H.

148 • FLORIDA HEALTH NOTES

Financing and Personnel

The State Board of Health has lacked adequate funds to carry
on an effective statewide air pollution control program and lacked
the ability to use funds to attract personnel because of poor salary
schedules.

Howard W. Chapman, associate regional health director for
environmental health services for Region IV of the U. S. Public
Health Service, has noted that, according to 1965 data, the State
Board of Health spent approximately $176,000 for air pollution
activities. But $146,000 of this amount was spent in the Polk-
Hillsborobgh Air Pollution Control District, leaving only $30,000
for the rest of the state. The per capita expenditure in the district
was about 23.4 cents, while in the remainder of the state, it was
0.6 cents. This amount is far below the national average of four
cents per capita per year spent on air pollution control. In gen-
eral, a comprehensive state air pollution control program that in-
cludes studies, technical assistance to local program, plan review
and approval, and enforcement authority should have a minimum
budget of from two to five cents per capita per year.**

In addition to the monies the State Board of Health has spent
on statewide air pollution control, several county and local pro-
grams are in existence. A total of $88,856 was spent in 1965-66
by the Dade County Department of Public Health; Palm Beach
and Manatee County Health Departments are spending $68,584
and $64,248, respectively, in 1966-67; and the Jacksonville-Duval
Air Improvement Authority has budgeted $80,000 for the current
fiscal year.

Despite the shortcomings of Florida and the problems that it
faces, the state ranks fifth in the list of states and territories in
the expending of non-Federal funds for air pollution. The Con-
servation Foundation Commentary shows that only California,
New York, New Jersey and Pennsylvania are ahead of Florida. 35

34. Appendix B (2). Letter from Howard W, Chapman to Wilson T. Sowder, Stat* Health
Officer.

35. ConMrrnatiBix Foundation Cammrntarif. publl»h«j by Conservation Foundation. Washing-ton.
D. C. July IB. 1966. p. 17.

FLORIDA HEALTH NOTES ♦ 149

To overcome the deficiencies of the past, the State Board of
Health is requesting a total of $6.5 million for air and water pol-
lution control and associated environmental health programs. A
request is being submitted to the State Legislature for $5 mil-
lion, of which $1.5 million will be used as grants-in-aid to County
Health Departments to be used for local programs. The balance will
go for state-supported projects. The additional $1.5 million is to
be requested through local matching funds by the State Board of
Health.

A total of $345,400 has been requested for the Bureau of
Sanitary Engineering for air pollution control in the current
biennium. Approximately $840,000 is being requested for the 1967-
69 biennium. The State Board of Health is seeking $100,000 in
the budget for construction of additional facilities at the Winter
Haven station.

Equipment for air pollution control has a high price tag. The
demands for trained personnel in this discipline considerably ex-
ceed the supply. The competition is fierce and the situation is
getting worse. The State Board of Health has acute difficulty in
obtaining qualified engineers because the salary schedule set under
state regulations is not competitive with the Federal Government
and private industry." At the present time the air pollution con-
trol program has a staff of 17 persons. When a vacancy occurs,
it is extremely difficult to recruit qualified personnel to fill it.
Under the expanding program for air pollution control, the State
Board of Health is budgeting for 26 new positions.

Legal Action by the State Board of Health

Below are some of the more than 19 legal actions taken by
the State Board of Health on behalf of the citizens of Florida
since 1958 in relation to air pollution control. Some of these cases
were dismissed by the court; others were dropped because in the
opinion of the solicitor "prosecution was not justified"; other
cases were not pressed because efforts were made by the offending

3*. Op. Ctt. FitUra, Vincent D.

150

FLORIDA HEALTH NOTES

companies or municipalities to correct the situations before the
cases went to court.

State Board of Health vs. Armour and Company

Air pollution at Ft. Meade plant prior to March 5, 1963, fol-
lowing severe air inversion condition was alleged to cause nose bleed
and defoliation of vegetation in Ft. Meade area. This was linked to
the company failing to construct a phosphate plant with approved
air pollution control devices. An injunction was sought to stop
plant operations until air pollution control devices were installed.
DISPOSITION: The court allowed continued operation of plant
and continued this case for 120 days to allow company to install
adequate approved control devices, after which case was dismissed.

State Board of Health vs. International Minerals
and Chemical Corporation

Air pollution was from the Prairie plant, January 5, 1965.
Violation of Air Pollution Control Commission rule requiring ade-
quate control measures during operations which company had
failed to install and operate. Case presented before Commission
in an administrative proceeding. DISPOSITION: Final order re-
quired compliance by October 1, 1965; company complied with
order and case dismissed.

State Board of Health vs. the City of Dania

Air pollution condition caused by open burning of city garbage
dump. Upon commitments of the City to correct the situation,
case dismissed after one year.

Health and Economic Factors

Some segments of the population are interested in air pollu-
tion because it soils or damages the paint on their homes. This
condition also interferes with the proper growth of certain orna-
mental plants and shrubs. Other people seek the abatement of
air pollution primarily because they are tired of brushing soot

FLORIDA HEALTH NOTES

151

off the sill every time they open a window for a breath of more-or-
less fresh air.

Others seek an end to air pollution because their citrus groves
will not flourish or because their cattle will not grow properly in
an atmosphere contaminated with certain fluorides or oxides.
Some people, such as city planners, airline pilots and farmers,
seek an end to air pollution because it interferes with the proper
performance of their professions.

There are many who seek an end to air pollution because they
don't like the odors that assail them where they live or work;
and many are chagrined because the mountains or the forests
or other aesthetic delights that they enjoyed as children are now
obscured by a blanket of smog on too many days of the year.

Each of these individuals has good reasons for wanting to see
the myriad sources of air pollution abated. The primary reason
they favor control is that air pollution threatens human health.
The threat to health constitutes the primary impulse for the
control of air pollution by the State Board of Health and the
Federal Government. 87

While air pollution is a health factor, the control of air pol-
lution is also an economic factor. The cost of research, the in-
stallation and operation of devices runs into millions of dollars.
By January 1, 1966, the phosphate industry had spent $22.7 mil-
lion on research, development and installation of air pollution con-
trol equipment. In addition, equipment valued at $6 million is
either on order or being installed and the annual operating cost
is slightly in excess of $3 million. 38 But industries which have
pollution potentials must assume their responsibilities for pol-
luting the air that people breathe and initiate steps to prevent
this contamination. Prevention can be either through control of
pollution at its source, such as the result of a manufacturing
process, or through proper engineering of products sold to the

37. Op. Cit, Stewart. William H.

38. Op. Cit. Fatton, Vincent D.

152 • FLORIDA HEALTH NOTES

I

I

I

consumer, such as automobiles, which add considerably to the I

problem.

Part of the answer to air pollution control is zoning but the
State Board of Health has no authority in this field. Areas zoned
for heavy industry and residences should have a buffer zane of
light industry and commercial establishments between them. This
would keep noise, smoke, heat, vibrations and particulate and
gaseous pollution emissions from greatly affecting residential
areas. Planning and zoning are still in their infancy and while
most of the incorporated towns and cities have some type of zon-
ing, only a few counties have zoning in unincorporated areas. A
special act of the Legislature is needed before a county can adopt
zoning laws.

The Surgeon General of the U. S. Public Health Service has
noted, "Air pollution officials find themselves in a particularly
difficult position. In recent years the ground has shifted beneath
their feet. Efforts which were regarded as acceptable just a few
years ago are now considered inadequate. They are being asked
to shift gears very rapidly. In order to do so productively, they
cannot continue to follow stereotyped patterns which may have
served them well in the past but which are no longer adequate
to the challenges ahead. Today, air pollution control officials con-
front the problems of a computerized automated space age but
they are still armed for the most part, with the weapons of
yesterday." 39

Air pollution is a problem in certain areas of Florida, The
largest and most persistently troubled spot is the Polk-Hillsborough
District which has had national and international notoriety but
there are other pockets of air pollution which could become in-
creasingly damaging to the Sunshine State's image. Air pollution
not only affects the health of Florida's citizens but it hurts the
economic wealth of the state. The people of Florida need to look
at the situation now and arm the State Board of Health with the
tools and resources which it has asked for to meet the challenges
of tomorrow.

SB. Op, Ct'(. Stewart, William H.

FLORIDA HEALTH NOTES • 153

SELECTED BIBLIOGRAPHY

PUBLISHED BOOKS

Florida Administrative Code, Office of the Secretary of State,

Tallahassee, Florida.
Florida Statutes, State of Florida, Tallahassee, Florida

Harding, Charles L, McKee, Samuel B., and Schueneman, J. J.
A Report on Florida's Air Resources, Florida State Board of Health,
Jacksonville, Florida, February 1966.

Sheehy, J. P. et al. "A Pilot Study of Air Pollution in Jacksonville,
Florida." U. S. Department of Health, Education, and Welfare,
Public Health Service, Division of Air Pollution, Washington,
D. C, April 1963.

MAGAZINES, NEWSPAPERS AND PAMPHLETS

"Air Pollution" Florida Health Notes, Florida State Board of
Health. Jacksonville, Florida. Vol. 57, No, 1, January 1965.

Eagdikian, Ben H. "Death in Our Air." The Saturday Evening
Post. Curtis Publishing Company, Philadelphia, Pa. October 8,
1966. No. 21.

Berland, Theodore. "Our Dirty Sky." Today's Health. American
Medical Association, Chicago, Illinois, March 1966.

Harmon, Tom. "Officials Look to Science for Air Pollution Solu-
tion" Tampa Tribune. July 10, 1966.

"State Level Said Starting Point for Air Pollution

Control." Tampa Tribune. July 12, 1966.

Stewart, William H., Surgeon General of U. S. Public Health
Service. "Air Pollution — Time for Action" paper presented at
the 59th Annual Meeting of the Air Pollution Control Associa-
tion, San Francisco, California, June 20, 1966. Published by
U. S. Department of Health, Education, and Welfare, Public
Health Service, Washington, D. C.

UNPUBLISHED PAPERS AND REPORTS

Patton, Vincent D. "Florida's Air Pollution Problem." Paper
presented before Florida Chapter, American Public Works As-
sociation. Sixth Annual Convention, Tampa, Florida, May 5,
1966.

154 • FLORIDA HEALTH NOTES

APPENDIX A

"The Health Effects of Air Pollution in Polk County"

FLORIDA HEALTH NOTES • 155

APPENDIX A

THE HEALTH EFFECTS OF AIR POLLUTION
IN POLK COUNTY

by

Albert V. Hardy, M.D., Dr. P.H., Director, Bureau of Research,
Florida State Board of Health

Charlton Prather, M.D., M.P.H., Assistant Director, Bureau of
Preventable Diseases, Florida State Board of Health

Beginning in March 1966, pages of identical petitions addressed
to the Florida State Board of Health and the Florida Air Pollution
Control Commission were received by Mr. Vince Patton, Secretary,
Florida Air Pollution Control Commission. The last 12 sheets, each
with 21 signatures, were received in early July. Counting both the
Mr. and Mrs. included in one signature, there were 4631 names on
these petitions. There were in all approximately 4000 signatures
representing about 3000 families.

The complaints in the petition were broad and included a gen-
eral request for relief. It was worded as follows :

"Gentlemen: We respectfully request that you take immediate
and resolute action to prevent and abate the acid gases, fumes,
chemicals, and toxic particles which are continuously being spilled
into the air in the Polk -Hillsborough Air Pollution Control Dis-
trict, at an enormous rate, especially in the Western Part of Polk
County. We do not know what steps should be taken to control
this serious menace. However, as experts on air pollution and
charged with the responsibility under the laws of this State of
Florida to control it, we respectfully request your help."

There was no indication as to the specific harmful effects of
"this serious menace" as conceived by the signers. Hence, the
State Health Officer directed the Bureau of Research and the
Division of Epidemiology of the State Board of Health to de-
termine the extent to which air pollution did damage the health
or impair the comfort of individuals signing this petition. This is
the report of findings:

More precise information from the signers was essential. The
petition provided names and addresses but the latter were com-

156

FLORIDA HEALTH NOTES

monly incomplete and many signatures were difficult or impossible
to read. Using available directories, secretaries in the Polk County
Health Department clarified names and completed addresses in-
sofar as possible. The purpose was to contact by mail a 1000
family sample of the petitioners. As a trial run, each fiftieth
signer was contacted. Next all with two signatures per family
were mailed the questionnaire, the remainder were those with one
name per address. To reach the 1000 virtually all usable house-
hold addresses had to be included. Other than omitting odd and
presumed fictitious groups of names, there was no selection except
that based on the readability of names and adequacy of address.
None of those families whose names were on petitions received
in July were contacted. The geographic distribution of the sample
compared closely with that of all addresses on the petition.

The letter of request and the one page questionnaire employed
are attached to this report. Attention was directed particularly to
the effects of the "irritating and toxic" pollutants on the health of
the petitioner and his family. The first question was "Within the
past 12 months have you or another member of your household
suffered any personal annoyance, irritation, or health effects re-
lated to air pollution?" This was to be answered by circling "yes,"
"no," or "don't know." For those answering "yes," the further
questions called for identification of name(s) of family member (s)
affected. A description of the annoyance, irritation or health ef-
fect was requested with dates and places of occurrence as exactly
as possible. If a physician had been consulted the questionnaire
called for his name, address and an authorization for him to give
further information on the medical condition to a representative
of the Board of Health.

This inquiry, a self-addressed postage prepaid envelope in-
cluded, elicited a response from 195 (19.57c) of the 1000 con-
tacted (Table 1). The post office returned an additional 38 with
the stamped information that the addressee was unknown, had
moved and left no address, or that there was no such street or
street number. The responses came slowly. After more than two
months a follow-up letter was sent to each fourth nonrespondent,
i.e., to 192 of the 767 nonrespondents. To this communication
30 (15.6%) replied (and nine envelopes were returned "addresses
unknown"). Thereafter with the aid of the Polk County Health
Department staff there was an intensive effort to reach the 153
who failed to respond to the follow-up communication. The perma-
nent residents were interviewed. When it was determined that
the signers of the petition were apparently temporary residents,
predominantly winter guests, the follow-up efforts were stopped.

FLORIDA HEALTH NOTES • 157

VOLUNTEERED COMMENTS ON HOW SIGNATURES
WERE PROCURED

There was no inquiry designed to ascertain the circumstances
under which individuals signed this petition. The information re-
ceived was volunteered. Undoubtedly many signed from deep
conviction but there was ample evidence that this was not always
the case. The following are illustrative comments:

1. "I signed the petition because of a personal request of a
friend and as far as I know, I have had no personal injury. I feel
the program of control is well handled and a great deal of progress
has been made."

2. "I am sorry about this matter. I was mis-informed. My
husband works for one of the phosphate plants (which was des-
ignated) for 21 years. The mine has been our bread and butter.
We have not been harmed in any way mentioned above. Thank
you. P.S. The dust does get pretty bad."

3. "I signed the petition to get away from a very persistent
woman. This won't happen again and if possible I would like to
get my name removed from said petition."

4. "My husband signed this petition against his better judge-
ment one day at Sears Town Shopping Center. S3me woman
just wouldn't take no for an answer. We know nothing about pol-
lution in our area."

5. "Having signed the referred to petition on the spur of the
moment without a second thought, I would appreciate very much
having my name removed from said petition. Thank you."

6. "A petition was in the office of the park where I live in
the winter. They were asking all to sign it and it seemed like
a good idea."

7. "I don't remember signing the petition."

8. "I refused to sign this petition and so did my wife. We
have no complaints."

9. "I am not aware of signing any such petition. I have no
idea of what this is all about."

10. "I know nothing about this request and wish I had a
photostat copy of my name if it was in handwriting on that
petition. Thank you kindly for writing me."

158 • FLORIDA HEALTH NOTES

Several replies stated the petition was signed for reasons other
than health, as for example:

1. "My interest in signing the petition related to damage being
done to citrus and cattle in our area and in no wise did we have
in mind human danger."

2. "My signature was affixed to the petition mentioned through
my interest in agriculture, not from the personal health hazard
aspect."

In reviewing these petitions an alert secretary found that there
were instances of repetition of the same signature. She noted
one name on five different sheets. There were occasional groups
of very odd names suggesting playful actions. In an individual
follow-up in the home, a ten-year-old child said she signed at
school because the teacher told her to do so. These observations
are reported to provide a perspective for weighing the significance
of the large number of signatures on these petitions.

FINDINGS

It is recognized that the observations to be reported are not
the findings on a representative sample of the population. As
indicated above, varying motives and circumstances caused in-
dividuals to add their names to the petition. However, those most
likely to sign were individuals concerned about air pollution in
the area, and particularly those who believed they were per-
sonally affected by it. Thus, the findings would reveal the occur-
rence and nature of health problems attributed by the petitioners
to air pollution. However, the indicated magnitude of the prob-
lem among them would not be a measure of that for the population
as a whole. The purpose of the study was to ascertain the nature
and frequency of the complaints and to collect evidence as to the
probable relation to air pollution.

There was a striking difference in the information provided
in the responses to the first and second mailings and in the per-
sonal contacts by phone and home visits (Table 2). Of the 195
who responded to the first mailing, 123 (63%) had complaints,
approximately two-thirds specifically related to health. From the
second mailing to the sample of 192 nonrespondents, four (13%)
of 30 responses cited complaints. During the individual follow-up,
there were only two (3%) complaints from 78 residents who
were contacted and provided information. Furthermore, complaints
received in the responses to the second mailing and those stated
in the interviews during the individual follow-up were less trouble-
some than those reported in the answers to the first mailing.

FLORIDA HEALTH NOTES

159

Table 3 summarizes the statistical distribution of observations.
The numbers are based on a direct count of the returns to the
first mailing to the 1000 families together with the actual num-
bers on the 25% sample of nonrespondents multiplied by four.
While 14.7% had complaints, 49.6% had no complaints. It was
determined that 15.6% of those who signed the petition but failed
to answer communications were winter residents, and an additional
14.1% were unknown at the address given and are presumed to
be transients or temporary residents. There was emphatic asser-
tion by 2.4% that the petition had not been signed by them. Of
those contacted individually 1.2% promised to provide the in-
formation by mail but have failed to do so and 1.27c refused to
answer questions. Death had occurred in 0.4% of the petitioners.

The complaints varied in degree. For descriptive purposes the
annoyance and irritations were separated from the more definite
complaints related to health. For the groups as a whole, 8.8%
considered that their health had been impaired; an additional
5.9% considered they were otherwise affected by air pollution.

Members of one group complained in a strikingly uniform man-
ner. Predominatly these were residents, and chiefly winter resi-
dents, in large trailer courts. They directed their complaints to
one plant which was repeatedly named. Illustrative comments fol-
low:

1. "When the Kraft plant is operating, the emission from their
smoke stack coats everything with oily, sooty, type substance
which must be washed off every day."

2. "There is the annoyance of having black, sticky, oily parti-
cles all over the mobile home, automobile and porch furniture.
Constantly having to wash windows, house and car is irritating
to older people and this no doubt affects their health."

3. "I live close to the Kraft plant and the black soot covers
everything. It is annoying but I have not been affected in any
way I know of."

4. "Pollution must be harmful as it produces sneezing when
dust is wiped from furniture."

6. "Surely with the odor as well as black oily particles it is
not healthy. Who knows how long it will take to have permanent
effect on your health?"

In marked contrast with the frequency of mention of Kraft,
a specific phosphate plant was named in only three responses.
However, complaints apparently related to the industry as a whole

160

FLORIDA HEALTH NOTES

commonly specified significant eye or respiratory tract symptoms.
Burning- of the eyes, irritation of the nose and throat, and ex-
cessive coughing were mentioned frequently. Symptoms of an
asthmatic nature or an aggravation of asthma appeared to be par-
ticularly troublesome. Sinus trouble and post-nasal drip were cited
repeatedly. Episodes of nose bleeding were of concern, particularly
in one school. Symptoms related to arthritis were mentioned oc-
casionally. An aggravation of emphysema from the air pollution
was considered to be "very bad." The following are illustrative
of the health complaints specified : "Throat and nose irritation
causing sinusitis and coughing which in turn caused aching joints,
low blood and anemia"; "Stinging sensation in nose and throat —
bad odor"; "Throat irritation, coughing interferes with breathing,
unpleasant odor"; "I have emphysema and when the wind is from
the West I almost choke to death. I have to go to the hospital" ; "A
heavy pall of smoke causes burning of eyes and throat" ; "Noticed
choking sensation when air has a visible fog from nearby phos-
phate operation"; "Fumes irritate eyes and mucous membranes
of nasal and throat passages"; "Irritation of nose and lungs and
sinuses on days when low clouds and humidity keep phosphate
particles low to the ground."

The questionnaire inquired as to the date and place of occur-
rence of symptoms. With only a few exceptions no information
was provided. When this was answered the information tended
to be very general as "many times," "off and on," "before Christ-
mas" or "past several months." The specific dates given did not
cluster sufficiently to point to a precise day or a particular month.
However, there were instances where both a day and hour were
stated. The indefinite responses may reflect only the uncertainties
of memory of past events.

The geographic distribution of all signers of the petition, of
the sample mailed the questionnaire, and of those specifying com-
plaints considered related to air pollution is given in Table 4. The
distribution of the sample and of the total, corresponded satis-
factorily. The percentage of those queried and of those citing
complaints varied only slightly in the Lakeland-Bartow com-
munities. It was a little lower in Hillsborough (chiefly the eastern
area) but substantially lower in Winter Haven and Highlands City
areas. There were no complaints from the few queried who lived
in East Polk County or outside of Polk and Hillsborough Coun-
ties. One out-of-state resident forwarded an unsolicited letter of
complaint. The percentage of replies with complaints is shown
further in Table 5.

FLORIDA HEALTH NOTES • 161

Of 30 petitioners who had consulted a physician, 28 gave per-
mission for their doctor to furnish information. Eleven physicians
were involved; all were contacted. Opinions on the role of air
pollution in 25 cases were given. In one community, one of the
physicians was convinced the air pollution was a very significant
contributor to the complaints of 11 of his patients. However,
a fellow practitioner in the same community did not attribute
symptoms in his cases to this cause. One physician clearly identi-
fied the cause of asthmatic attacks in one patient as pollution de-
rived from fogging for mosquito control. Another had a patient
whose symptoms he related to air pollution from industrial sources.
In the other 12 cases in which medical opinions were expressed, it
was concluded that in five symptoms might be related and seven
were unrelated to air pollution.

The difficulty of evaluating the causal relationship of air pol-
lution to morbidity is widely acknowledged. Most of the symptoms
are those which occur with greater or lesser frequency in every
community. Those reporting believed these to be aggravated by
air pollution. Conclusive proof would require dependable data
from comparable population groups with and without exposure to
air pollution, a rarely attainable situation. Investigators from the
University of Cincinnati who are devoting intensive attention to
the problem report in the August 1966 issue of Archives of En-
vironmental Health. Their introductory statement is "Of the
many difficult epidemiological undertakings of recent years the
more ambitious have been attempts to establish possible effects
on health of varying levels of air pollution and different types of
pollutants found in the atmosphere of American cities." Their
studies were conducted in Cincinnati and Los Angeles. However,
the reported findings related only to Los Angeles since, as they
say, "The air pollution and morbidity data from Los Angeles pro-
vided a large enough population base to bring the study to a
successful conclusion." The lack of conclusive medical evidence
from studies in much smaller communities might therefore be
anticipated.

In the effort to be objective in weighing information, one must
recognize the tendency of complainants to attribute the deed to
a suspect culprit. In the health field this was reflected by one
petitioner who stated that due to air pollution she had "been
unable to sleep with windows open at night — have air conditioned
our house for more restful nights." Another reported a salesman's
charge of damage by air pollution: "I bought carpeting. It faded.
I complained to the dealer so a representative of the company
came to see about it. He said it was due to the fumes from the
phosphate industries and gave me a big talk about chemical re-
action, etc. I bought a new rug from another company to replace

162

FLORIDA HEALTH NOTES

it — so it cost me extra money. We'll see what happens to it."
This respondent at least was willing to wait for confirmatory evi-
dence.

POSSIBLE ROLE OF VARIOUS POLLUTANTS ON HEALTH

On two previous occasions substantial studies to ascertain
the health effects of air pollution in Polk County have been en-
couraged or conducted by the Board of Health. In one the Public
Health Committee of the Polk County Medical Society requested
the practitioners to provide the names of patients with symptoms
possibly due to air pollution. These patients were invited to pre-
sent themselves for additional examination. The report stated the
conclusion that after extensive investigation of fluoride intoxica-
tion in humans in Polk County, the Public Health Committee of
the Polk County Medical Society found no evidence of any harm-
ful effects. The condition of the teeth is a particularly sensitive
index of possible exposure to increased amounts of fluorides.
Hence, 2539 children in four schools were given special dental
examinations, three in West Polk County and a control school in
the eastern part of the county. Only two children with very mild
and one with mild mottling considered related to fluoride intake
were found. The proportion with caries was the same in the three
communities exposed to air pollution and in the one control com-
munity. It was concluded there was no significant evidence of
either harmful or beneficial effects of fluorides due to air pol-
lution in Polk County.

The nature of the prominent symptoms cited, notably irritation
of eyes, nose and throat, and aggravation of sinusitis, asthma and
the manifestations of emphysema points to a causal relationship
with chemical irritants such as the sulfur oxides. Evidence ac-
cumulated in this study is suggestive.

CONCLUSIONS:

Despite uncertainties in the evidence and in the interpretation
of it, we must conclude that, at least, 14.7, per cent of a family
sample of 1000 petitioners on air pollution in Polk-Hillsborough
Counties felt they had been annoyed or injured by air pollution
in the preceding 12 months. This is a significant problem of
mental health and tranquility, if no other. Attempts to assess
actual physical damage from air pollution are fraught with great
difficulties in the best designed studies and there were no ex-
ceptions to this in the present one. Few of the complaining peti-
tioners had sought medical attention for their symptoms and of
those who had had such attention, the physicians' impressions were
that 13 of the 28 could be related in some way to atmospheric

FLORIDA HEALTH NOTES •

pollution. This association of air pollution with actual physical
damage, though not completely verified, cannot be ignored. The
nature of the complaints of the petitioners and their geographic
location of residence, make it a reasonable assumption the symp-
toms were related to air pollution episodes with irritant chemicals
of which the sulfur oxides or oily soots were the most likely air
contaminants.

This problem has been of continuing concern to the Florida
State Board of Health. The maintenance of an environment con-
ducive to good health is one of the multiple reasons for seeking
more rapid control of air pollution in the Polk-Hillsborough area
of central Florida and in any other area of Florida with similar
problems.

It has been concluded further by Dr. Wilson Sowder, State
Health Officer, that the retrospective evidence on the health ef-
fects of air pollution in the Polk- Hillsborough Air Pollution Dis-
trict indicates the need for more definitive prospective observa-
tions. He has directed that continuing studies of this type be
planned and has assured that appropriate field assistance can be
made available. He has expressed the hope also that the Polk
County Health Department may soon have the leadership of a
highly competent health officer who would be an essential team
member in such a study. Prompt reporting of symptoms believed
due to air pollution will be required. Dr. Sowder urges the con-
tinued interest and participation of concerned citizens in the
Polk-Hillsborough Air Pollution Control District.

TABLE 1

CLASSIFICATION OF FAMILY RESPONDENTS
POLK COUNTY AIR POLLUTION INVESTIGATION, 1966

Original mailing

1000

Responses

195

(19.5%)

Returned undelivered

38

( 3.8%)

Nonrespondents

767

Second mailing (1.4 sample)

192

Mail responses

30

(15.6%)

Returned undelivered

9

( 4.7%)

)llow-up by phone

and home visits

153

164

FLORIDA HEALTH NOTES

I

I

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TABLE 2 I

RESPONSES ON FIRST AND SECOND MAILING

AND ON FAMILY FOLLOW-UP POLK COUNTY

AIR POLLUTION INVESTIGATION, 1966

Returns from original mailing

195

No complaints

72

Complaints

123

Annoyance or irritation

39

Health effects

84

Other

38

Returns from second mailing

39

No complaints

26

Complaints

4

Annoyance or irritation

4

Health effects

Other

9

Individual follow-up

No complaints

76

Complaints

2

Annoyance or irritation

1

Health effects

1

Other

75

TABLE 3

DISTRIBUTION OF OBSERVATIONS

BASED ON SAMPLES STUDIED

POLK COUNTY AIR POLLUTION INVESTIGATION, 1966'

Total sample, families
No complaints
Complaints

Annoyance or irritation 59 {5.9% )

Health effects 83 (8.8%)

Winter guests

Presumed temporary residents
Did not sign

Information promised by mail
Information refused
Dead

'Numbers based on first returns from mailings to the 1000 fami-
lies together with the follow-up observations on the 25 per cent
sample of nonrespondents.

FLORIDA HEALTH NOTES • 165

umber

Per cent

1000

100

504

50.4

147

14.7

156

15.6

141

14.1

24

2.4

12

1.2

12

1.2

4

0.4

TABLE 4

PERCENTAGE DISTRIBUTION OF FAMILY RESPONDENTS

BY GEOGRAPHIC AREAS
POLK COUNTY AIR POLLUTION INVESTIGATION, 1966

Total

Replies with

Area

Signers

Sample

Complaints

Lakeland City

37.1

37.9

43.0

Lakeland Rural

5.8

6.9

6.3

Lakeland Mobile Homes

20.5

20.2

22.5

Bartow Area

13.8

16.9

17.6

Winter Haven Area

6.3

4.7

1.4

Highlands City

3.0

2.7

1.4

East Polk County

1.3

.7

Hillsborough County

8.6

9.2

7.7

Elsewhere

3.5

1.7

TOTAL NUMBERS

4631

1000

142

TABLE 5

PERCENTAGE OF REPLIES WITH COMPLAINTS
POLK COUNTY AIR POLLUTION INVESTIGATION, 1966

Lakeland City
Lakeland Rural

14.8
13.8

Lakeland Mobile Homes

14.5

Bartow Area

13.6

Highlands City
Winter Haven

6.9
3.9

East Polk County
Hillsborough County
Elsewhere

10.9

166

FLORIDA HEALTH NOTES

FLORIDA STATE BOARD OF HEALTH

Wilson T. Sowder, M. D., M.P.H., State Health Officer

Malcolm J. Ford, M.D., M.P.H., Deputy State Health Officer

Jacksonville, 32201

BUREAU OF RESEARCH

Albert V. Hardy, M.D., Dr.P.H.

Assistant State Health Officer

and Bureau Director

We have the petition signed by you and addressed to the
Florida State Board of Health and the Florida Air Pollution Con-
trol Commission. By your signature you ask that these agencies
"take immediate and resolute action to prevent and abate the
acid gases, fumes, chemicals and toxic particles which are con-
tinuously being spilled into the air — at an enormous rate." We
are asking your further assistance in providing evidence which
may aid in identifying the sources, distribution and time of oc-
currence of pollution by these irritating and toxic substances, and
the effects of these on you and your health.

You are one of a representative sample of those persons sign-
ing the petition who is being requested to furnish more informa-
tion. Your cooperation in completing the attached questionnaire
and returning it promptly will aid the State Board of Health.
Your response will be regarded as confidential. Thank you.

Sincerely,

Albert V. Hardy, M.D.
Director, Bureau of Research

Charlton Prather, M.D.
Asst. Director, Bureau
of Preventable Diseases

AVH:ew
enc.

FLORIDA HEALTH NOTES • 167

FLORIDA STATE BOARD OF HEALTH
POLK COUNTY AIR POLLUTION SURVEY FORM

Please answer the following questions to the best of your ability and
return in the attached self -addressed envelope.

WITHIN THE PAST TWELVE (12) MONTHS, HAVE YOU OR
OTHER MEMBERS OF YOUR HOUSEHOLD SUFFERED ANY
PERSONAL ANNOYANCE, IRRITATION, OR HEALTH EF-
FECTS RELATED TO A Hi POLLUTION?

YES NO DON'T KNOW (Circle correct answer)

IF YES: Have you, yourself, been affected? YES NO

(Circle correct answer)

Names of others in your household affected: — -

Briefly describe how affected:

Give date(s) and place (s) (as exactly as possible)

Date Place -

Date Place

Was a physician consulted for diagnosis and treatment for above?

YES NO (Circle correct answer)

If physician (s) consulted for above, give name(s) and address (es)

Dr Address -

Dr. Address

The physician is □ is not □ (check one) authorized to give
further information on the above to a Board of Health represen-
tative.
ADDITIONAL INFORMATION:

(Use reverse side if necessary)

DATE

TELEPHONE NO „

Signature

Home Address

AVH:ew

168 • FLORIDA HEALTH NOTES

APPENDIX B

(1) Letter from Wilson T. Sowder, M.D.,
Florida State Health Officer, to H. B.
Cottrell, M.D., Regional Health Direc-
tor, U. S. Public Health Service, Reg-
ion IV.

(2) Letter from Howard W. Chapman, As-
sociate Regional Health Director of
Environmental Health Services, U. S.
Public Health Service, Region IV, to
Wilson T. Sowder, M.D., Florida State
Health Officer.

FLORIDA HEALTH NOTES • 169

APPENDIX B(l)

August 12, 1966

H. B. Cottrell, M.D.

Regional Health Director

U. S. Public Health Service— Region IV

50 Seventh St., N.E.

Atlanta, Georgia 30323

ATTENTION: Mr. Howard Chapman

Dear Doctor Cottrell:

Enclosed is a copy of a recent memo of mine concerning the
Florida State Board of Health's interest in an improved public
information program, especially on air and water pollution con-
trol programs. I am bringing this to your attention because I
think it wou'd be helpful to the Florida State Board of Health
to obtain your thoughts and assistance on this matter.

In particular, I would like to request a very brief report com-
paring Florida pollution problems and control programs to other
states in your region or perhaps to the rest of the country- If
you can meet this request, I think you would satisfy our needs
by limiting your response to an evaluation and comments on ma-
terials, information, and impressions you already have on hand.
I know this may restrict you to making only general observations ;
however, I do not believe our situation or public information pur-
poses warrant anything more than that at this time. Your per-
mission to publicly quote any of the comments you may be able
to send will be appreciated.

Sincerely,

Wilson T. Sowder. M.D.
State Health Officer

WTS:mw
Enc.

170 • FLORIDA HEALTH NOTES

APPENDIX B (2)

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

Regional Office

Rm. 404, 50 Seventh Street, N. E.

Atlanta, Georgia 30323 September 6, 1966

Dr. Wilson T. Sowder
State Health Officer
State Board of Health
Jacksonville, Florida 32201

Dear Dr. Sowder:

This is in regard to your letter of August 12 to Dr. Cottrell,
requesting a brief report on Florida's water and air pollution
problems and control program. Enclosed with your letter was
a copy of your July 28 memorandum to County Health Officers,
etc., on "Information Program and Legislative and Budgetary Pro-
posals on Air and Water Pollution Control Programs," and a copy
of the proposed act "State Environmental Control Act."

To comply with your request it is necessary to treat air and
water pollution separately, as follows:

Water Pollution

In general, the Florida State Board of Health has done an
excellent job in obtaining treatment of wastes from municipalities.
The statistics on the number of municipal waste treatment plants
built in the State of Florida during the last few years are, in-
deed, most impressive. During the period 1961 through 1965, 1003
separate treatment plants were approved for construction. No
State within this Region, and only a few nationally, have had the
rate of population growth and urban expansion, with its accompany-
ing municipal waste problem, as has Florida.

The State Board of Health has carried out some extensive
studies on special local water pollution problems such as those
associated with the phosphate industry. These studies are com-
mendable, but staff resources should be available to cover all in-
dustrial wastes and stream problems in the State.

One of the real glaring weaknesses in Florida is State law
which exempts certain industrial areas from pollution control.
No State in the Southeast has similar exemptions in its law. Also,
as in other States, Florida has serious pollution problems relating
to the larger municipalities such as Jacksonville and Miami.

FLORIDA HEALTH NOTES • 171

In the "Staffing and Budgetary Guidelines for State Water
Pollution Control Agencies," prepared by the Public Administra-
tive Services, Chicago, Illinois, (see enclosed copy) it is suggested
that Florida have a minimum staff of 58 persons, but a staff of
93 persons for its water pollution control program would be more
desirable. To support this staff a minimum annual budget of
$528,000 would be required, and a desirable budget of $847,000.
Florida's present staff and budget is less than one-half of the
minimum recommended.

The Florida State Board of Health has an effective water pol-
lution control program which has done much to control or mini-
mize pollution in the State. However, to cope with the pollution
problems associated with population growth, urban and industrial
expansion, etc., the following is needed:

1. Strong legislation providing all the authority needed to do
a complete job.

2. Adequate budget and staff.

3. Initiate long-range planning for water pollution control
which includes a comprehensive approach for stream studies
and abatement of pollution from all municipalities and in-
dustries.

Air Pollution

Based on 1965 data, the Florida State Board of Health spent
approximately $176,000 for air pollution activities or approxi-
mately 3.5 cents per capita per year. The average in 35 states
during the same year was 4 cents. However, this comparison of
Florida with other states is somewhat misleading since approxi-
mately $146,000 of the $176,000 was spent in the Polk-Hills-
borough-District, leaving only $30,000 for the remainder of the
State. Therefore, the per capita per year expenditure in the Polk-
Hillsborough District was about 23,4 cents, and the remainder of
the State 0.6 cents. If Polk -Hillsborough District is considered
a "local" program, the expenditure of 23.4 cents per capita com-
pares favorably with the 1965 average of 22.6 cents for 130 local
programs. Obviously, the 0.6 cents per capita for the states ac-
tivities is much below the national average of 4 cents. In general,
a comprehensive state air pollution program that includes studies,
technical assistance to local programs, plan review and approval,
and enforcement authority should have a minimum budget of
from 2-5 cents per capita per year.

172 • FLORIDA HEALTH NOTES

I

I

!

Unquestionably, the State program and activities in the Polk-
Hillsborough District have effectively reduced air pollution emis-
sions in this area. This has been accomplished even though there
has been a tremendous expansion of the phosphate rock processing
industry within the last eight years. It is generally agreed, how-
ever, that the air pollution problems are not completely resolved
and much additional effort is needed. The Florida State Board
of Health is fortunate in having on its staff engineers who are
nationally recognized for their expertness in the field of air pol-
lution control from phosphate rock processing operations.

I would like to comment briefly on the proposal for $1,000,000
in grants for local air and water pollution control programs, as
well as the proposal to shift $500,000 from the State program to
the local program — providing, in all, $1,500,000 for local activities.

State grants to the more populated Counties, or to Counties
that have special or unusual problems, may be appropriate and
should be productive. According to the 1960 census, there were 11
Counties in the State with populations in excess of 100,000 and
10 with between 50,000 and 100,000. It is doubtful that Counties
with less than 50,000 population would have the resources, in-
terest, or variety of staff to mount a successful program in either
the water or air area. I would, therefore, suggest that if grants
are to be made to County health departments that specific criteria
or guidelines be developed and followed which would exclude grants
to Counties where it is doubtful a meaningful program could be
established, and where it is evident that the State could provide
the services better and more economically.

In addition, it is imperative to have a clear understanding of
the State and County health department roles. The local program
should supplement and compliment the State's program. The State
program should continue to have the responsibility for laboratory
services, setting of standards, provision of expert technical serv-
ices, comprehensive long-range planning and enforcement.

Sincerely yours,

Howard W. Chapman

Associate Regional Health Director

for Environmental Health Services

Enclosure

FLORIDA HEALTH NOTES • 173

■SI:?

4

These stacks at a chemical plant in Polk County are equipped with devices
at the top to help cut down air pollution. The plume seen may be vapor
from other port of the plant,

174

FLORIDA HEALTH NOTES

■M

i£Qfti£A state: UBflAflfl

These stacks at a chemical plant in Polk County are equipped with devices
at the top to help cut down air pollution. The plume seen may be vapor
from other part of the plant.

174

FLORIDA HEALTH NOTES

;

VO ME 59 — NO. 3

FLORIDA

HEALTH
NOTES

1 v*-*^B

|H( Br

Iw ^1

*A ; H

1967

Food and
Nutritionists

(Cover photo 1 Fruit and
vegetable cartoons, made by
a nutritionist, enthrall a
class of children in a Florida
school.

A State Board of Health
nutrition consultant teache
a class of expectant mother
about proper diets. Amaru
the various activities carrie
on, nutritionists . . .

FOOD and
Nutritionists

It is true "You are what you eat!'

Everything- in your body was once taken in as food. Foods con-
sumed are changed by chemical processes into blood, muscles,
bones, teeth, hair and skin. Food is converted into energy. Food be-
comes hormones that regulate body processes and the antibodies
that fight infections. Food is used to make the material to clot
blood and to rebuild and repair tissue. And food provides the body
with energy for work and play. Your choice of foods can provide
enough of the right materials for body building and carrying out
body functions.

For well-being, the body must be supplied with sufficient quanti-
ties of the 40 odd nutrients essential for health. Carbohydrates,
protein, fat, calcium and iron are the major nutrients. A large
number of other minerals and vitamins are essential in smaller

amounts.

If you are poorly nourished because of insufficient food or your
body has not the ability to use food properly, you may lack stature,
stamina and enthusiasm for life. Two-thirds of the world's popula-
tion does not have enough food to eat. Many millions are on the
e ige of starvation because of worn-out soil, ignorance, poor land
n anagement, greed on the part of fellow countrymen, the black
r trket or expansion of the population. In the United States, re-
' urces are available. You merely have to select from some 5000

od items in the markets to get the best food values.

FLORIDA HEALTH NOTES • 179

(Cover photo) Fruit ond
vegetable cartoons, made by
a nutritionist, enthrall a
class of children in a Florida
school.

A State Board of Healtl
nutrition consultant teache
a class of expectant mother
about proper diets. Amon<
the various activities carrie
on, nutritionists . . .

FOOD and
Nutritionists

It is true "You are what you eat !"

Everything in your body was once taken in as food. Foods con-
sumed are changed by chemical processes into blood, muscles,
bones, teeth, hair and skin. Food is converted into energy. Food be-
comes hormones that regulate body processes and the antibodies
that fight infections. Food is used to make the material to clot
blood and to rebuild and repair tissue. And food provides the body
with energy for work and play. Your choice of foods can provide
enough of the right materials for body building and carrying out
body functions.

For well-being, the body must be supplied with sufficient quanti-
ties of the 40 odd nutrients essential for health. Carbohydrates,
protein, fat, calcium and iron are the major nutrients. A large
number of other minerals and vitamins are essential in smaller
amounts.

Tf you are poorly nourished because of insufficient food or your

b dy has not the ability to use food properly, you may lack stature,

i imina and enthusiasm for life. Two-thirds of the world's popula-

; >n does not have enough food to eat. Many millions are on the

■ 1,'e of starvation because of worn-out soil, ignorance, poor land

inagement, greed on the part of fellow countrymen, the black

<rket or expansion of the population. In the United States, re-

irces are available. You merely have to select from some 5000

>d items in the markets to get the best food values.

FLORIDA HEALTH NOTES

179

This issue of Florida Health Notes tells you about the foods you
should eat each day, diet fads, nutritional services given mothers,
children, the elderly and low-income families, and the work of the
nutrition consultants of the State Board of Health and County
Health Departments.

Nutrition is the process by which your body takes in, absorbs and
assimilates food for growth and repair of worn out and injured
tissues and energy. The science of nutrition is based on chemistry,
biochemistry, physiology, agriculture and food technology. In-
vestigators study the various nutrients used by the body — in
health and disease. Nutritionists are people especially trained to
interpret and apply this scientific background and knowledge of
food composition into practical food guides. They assist you to un-
derstand your nutritional requirements, especially during periods
of growth and stress, and guide individuals who must modify their
food intake because of a metabolic disorder or disease condition.

Florida Food and Nutrition

Florida leads the nation in producing the foods that supply many
nutrients essential to life, growth and health. Oranges supply the
daily vitamin C on breakfast tables throughout the United States.
Fresh vegetables provide essential vitamins and minerals in the
meals of families in many of our northern states. Protein, required
for life itself and growth of the young, comes from Florida's beef,
seafood, poultry and dairy products.

How about our own people of Florida? How well nourished are
they? Nutrition consultants from the State Board of Health's Divi-
sion of Nutrition have learned that migrant workers who harvest

FLORIDA HEALTH NOTES

Published monthly by the Florida State Board of Health, Wilson T. Sowder, M.D., M.P.H
State Health Officer. Publication office. Box 210, Jacksonville, Florido 32201. Second ekBS
postage paid at Jacksonville, Florida, This publication is for individuals and institutions wi- ■
an interest in the state's health programs. Permission is given to quote anv story providin
credit is given to the Florida State Board of Health. Editor: Robert A. Schoonover, M.A
Division of Health Education.

VOLUME 59— NO 3 MARCH 19«

180 • FLORIDA HEALTH NOTES

... moke visits
to agricultural
experiment sta-
tions to learn
about advances
in food produc-
tion , . .

nutrient-rich fruits and vegetables suffer from nutritional de-
ficiencies. Their greatest dietary lack is vitamins C and A, both
supplied in most people's diets by citrus fruits, tomatoes and green
leafy vegetables. Nutritionists working with migrant workers have
observed diseases, such as rickets and kwashiorkor (malnutrition)
which are rarely seen elsewhere in the state.

Nutrition and Disease

Many Floridians are not as well nourished as they should and
( >uld be. Nutritionists, working in County Health Department
i 'inks, in schools and with community programs, find many health
; oblems which are related to poor diets. The most common health

oblem is overweight and obesity — which is more related to

fluence than poverty — but it reflects poor choices of kinds

id amounts of foods.

'•

FLORIDA HEALTH NOTES

181

This issue of Florida Health Notes tells you about the foods you
should eat each day, diet fads, nutritional services given mothers,
children, the elderly and low-income families, and the work of the
nutrition consultants of the State Board of Health and County
Health Departments.

Nutrition is the process by which your body takes in, absorbs and
assimilates food for growth and repair of worn out and Injured
tissues and energy. The science of nutrition is based on chemistry
biochemistry, physiology, agriculture and food technology. In-
vestigators study the various nutrients used by the body — in
health and disease. Nutritionists are people especially trained to
interpret and apply this scientific background and knowledge of
food composition into practical food guides. They assist you to un-
derstand your nutritional requirements, especially during periods
of growth and stress, and guide individuals who must modify their
food intake because of a metabolic disorder or disease condition.

Florida Food and Nutrition

Florida leads the nation in producing the foods that supply many
nutrients essential to life, growth and health. Oranges supply the
daily vitamin C on breakfast tables throughout the United States.
Fresh vegetables provide essential vitamins and minerals in the
meals of families in many of our northern states. Protein, required
for life itself and growth of the young, comes from Florida's beef.
seafood, poultry and dairy products.

How about our own people of Florida? How well nourished arc
they '! Nutrition consultants from the State Board of Health's Divi-
sion of Nutrition have learned that migrant workers who harvest

FLORIDA HEALTH NOTES

Published monthly by (he Fiorido Stole 6oord of Health w^on T Sowder, M.D. M.P I
State Health Officer, Publication office. Box 210, Jacksonville Florida 32201 Second eta
postage paid at Jacksonville. Florida, This publicat.on is tor individuals and institutions w
on interest in the state's health programs. Permission is given to quote any story provide
credit is given to the Florida State Board of Heolth. £d ror Robert A Schoonavor, M.'"
Division of Health Education

VOLUME 59 — NO. 3 MARCH If

180 • FLORIDA HEALTH NOTES

. . . moke visits
to agricultural
experiment sta-
tions to learn
about advances
in food produc-
tion . . .

nutrient-rich fruits and vegetables suffer from nutritional de-
ficiencies. Their greatest dietary lack is vitamins C and A, both
supplied in most people's diets by citrus fruits, tomatoes and green
leafy vegetables. Nutritionists working with migrant workers have
-lived diseases, such as rickets and kwashiorkor (malnutrition)
which are rarely seen elsewhere in the state.

Lit ri t ion and Disease

Many Floridians are not as well nourished as they should and
ukl be. Nutritionists, working in County Health Department
nics, in schools and with community programs, find many health
■Jblems which are related to poor diets. The most common health
oblem is overweight and obesity — which is more related to
i'luence than poverty — but it reflects poor choices of kinds
<1 amounts of foods.

FLORIDA HEALTH NOTES

181

Nutritionists advise mothers of overweight children and preg-
nant women who are gaining too much weight; speak to groups of
just plain fat adults ; and counsel persons with diabetes, heart dis-
eases and a myriad of other chronic conditions which are ag-
gravated by the burden of excess fat.

Obesity is a body condition marked by the storage of much fat
which is hard to carry around. It often is related during pregnancy
to toxemia, complications during labor and stillbirths. The condi-
tion is also associated with an increased number of respiratory
difficulties, more high blood pressure and coronary heart disease,
susceptibility to diabetes and greater risk under surgery. It has
been estimated that about 20 per cent of adult Americans are over-
weight to a degree that it poses a hazard to health and long life.

Medical authorities today are concerned about heart disease as
the number one killer in the United States. The fat in our diets has

. . . present inservice programs for public health nurses to widen the
knowledge about foods. . .

182

FLORIDA HEALTH NOTES

ween suggested as having a relationship to heart disease. This is an
irea still being studied by medical and nutritional scientists.

Nutritional anemias frequently noted by physicians result from
diets lacking protein, iron and vitamin C. This condition is of partic-
ular concern when found among expectant mothers and young
children. Dental caries (tooth decay) are reported by public health
dentists and considered to be associated with diets high in refined
sugar. Dentists also observe gum conditions which can be improved
by increasing the amount of vitamin C in the diet.

The Foods to Eat

No one food contains all of the nutrients in the amount you
need. Yet most foods do contain more than one nutrient. The key
to good nutrition for most people is to choose a variety of foods that
supply the vital nutrients in the required amounts. All of these
foods are available in Florida markets and familiar to most people.
The major portion of the daily diet should be selected every day
from the four food groups.

These food groups with recommended daily servings are :

MEAT GROUP
Two or more servings

Beef, veal, lamb, pork, variety

meats, such as liver, heart and

kidney; poultry and eggs, fish

and shellfish. As alternates —

cooked dry beans, cooked dry Count as serving: 2 to 3 ounces

peas, nuts, peanuts, peanut but- of lean cooked meat without

ter. bone ; 2 eggs ; 1 cup cooked dry

beans or peas; 4 tablespoons

peanut butter.

Foods in this group contribute protein needed for growth and
pair of body tissues — muscle, organs, blood, skin and hair. These
ods also provide iron, thiamine, riboflavin and niacin.

FLORIDA HEALTH NOTES

183

Nutritionists advise mothers of overweight children and preg-
nant women who are gaining too much weight ; speak to groups oi
just plain fat adults; and counsel persons with diabetes, heart dis-
eases and a myriad of other chronic conditions which are ag-
gravated by the burden of excess fat.

Obesity is a body condition marked by the storage of much fat
which is hard to carry around. It often is related during pregnancy
to toxemia, complications during labor and stillbirths. The condi-
tion is also associated with an increased number of respiratory
difficulties, more high blood pressure and coronary heart disease,
susceptibility to diabetes and greater risk under surgery. It has
been estimated that about 20 per cent of adult Americans are over-
weight to a degree that it poses a hazard to health and long life.

Medical authorities today are concerned about heart disease as
the number one killer in the United States. The fat in our diets has

. . . present inservice programs for public health nurses to widen the
knowledge about foods. . .

182

FLORIDA HEALTH NOTES

een suggested as having a relationship to heart disease. This is an
rea still being studied by medical and nutritional scientists.

Nutritional anemias frequently noted by physicians result from
iets lacking protein, iron and vitamin C. This condition is of partic-
ular concern when found among expectant mothers and young
t-hildren. Dental caries (tooth decay) are reported by public health
dentists and considered to be associated with diets high in refined
sugar. Dentists also observe gum conditions which can be improved
by increasing the amount of vitamin C in the diet.

The Foods to Eat

No one food contains all of the nutrients in the amount you
need. Yet most foods do contain more than one nutrient. The key
to good nutrition for most people is to choose a variety of foods that
supply the vital nutrients in the required amounts. All of these
foods are available in Florida markets and familiar to most people.
The major portion of the daily diet should be selected every day
from the four food groups.

These food groups with recommended daily servings are :

MEAT GROUP

Two or more servings

Beef, veal, lamb, pork, variety
meats, such as liver, heart and
kidney; poultry and eggs, fish
and shellfish. As alternates —

ked dry beans, cooked dry Count as serving: 2 to 3 ounces
I as, nuts, peanuts, peanut but- of lean cooked meat without
1 ''• bone; 2 eggs; 1 cup cooked dry

beans or peas ; 4 tablespoons

peanut butter.

Foods in this group contribute protein needed for growth and
jiair of body tissues — muscle, organs, blood, skin and hair. These
<tls also provide iron, thiamine, riboflavin and niacin.

FLORIDA HEALTH NOTES • 183

MILK GROUP

Some milk for everyone

Children under 9 years of age —

2 to 3 cups
Children 9 to 12 — 3 or more cups
Teenagers — 4 or more cups
Adults — 2 or more cups
Pregnant women — 3 or more

cups
Nursing mothers — 4 or more

cups

Milk can be fluid, whole, evap-
orated, skim, dry or buttermilk ;
Cheese and ice cream may re-
place part of the milk ; 1-inch
cube cheddar cheese = V2 CU P
milk;

^ cup cottage cheese — Ys cup
milk;
V2 CU P i ce cream — Vi cup milk

Milk is the leading source of calcium needed for bones and teeth.
It also provides high quality protein, riboflavin, vitamin A and
many other nutrients.

VEGETABLE-FRUIT GROUP

Four or more servings

Include — a citrus or other fruit or vegetable; important for
vitamin C which is needed for healthy gums and body tissues.

Good source — grapefruit or
grapefruit juice; orange or
orange juice; cantaloupe, guava,
mango, papaya, raw straw-
berries, broccoli, b r u s s e 1 s
sprouts, green pepper, sweet red
pepper.

A dark green or deep yellow
vegetable for vitamin A — at
least every other day. Vitamin
A is needed for growth, normal
vision and healthy condition of
the skin. Dark green and deep
yellow vegetables and a few
fruits; namely, broccoli, canta-
loupe, carrots, chard, collards,
kale, mango, persimmons, pump-

kin, spinach, sweet potatoes,
turnip greens and other dark
green leaves.

Fair source — honeydew melon,
lemon, tangerine or tangerine
juice, watermelon, asparagus,
raw cabbage, collards, garden
cress, kale, mustard greens,
irish potatoes and sweet pota-
toes cooked in the jacket; toma-
toes and tomato juice; turnip
greens.

If the food chosen for vitamin C
is also a good source of vitamin
A, the additional serving of J'
vitamin A food may be omitted

184

FLORIDA HEALTH HOTES

The remaining 1 to 3 or more servings may be of any vegetable
, r fruit. Fruits and vegetables are valuable because of the vitamins
,.nd minerals they contain. Count as 1 serving: i/ 2 cup of vegetable
nr fruit; or a portion as ordinarily served, such as 1 medium apple,
banana, orange or potato; half of a medium grapefruit or canta-
loupe or the juice of 1 lemon.

BREAD-CEREAL GROUP
Four or more servings

Whole grain, enriched or re-
stored. This group includes:
breads, cooked cereals, ready-to-
eat cereals, cornmeal, crackers,
flour, grits, macaroni and spa-
ghetti, noodles, rice, rolled oats,
quick breads and other baked
goods if made with whole grain
or enriched flour.

Count as 1 serving: 1 slice of
bread, 1 ounce ready - to - eat
cereal, i/ 2 to % cup cooked
cereal, cornmeal, grits, macaro-
ni, noodles, rice or spaghetti. If
no cereals are chosen, add an ex-
tra serving of bread or baked
goods making 5 servings from
this group.

. . . make and operate
exhibits for meetings
and conferences . . .

FLORIDA HEALTH NOTES

185

MILK GROUP

Some milk for everyone

Children under 9 years of age —

2 to 3 cups
Children 9 to 12 — 3 or more cups
Teenagers — 4 or more cups
Adults — 2 or more cups
Pregnant women — 3 or more

cups
Nursing mothers — 4 or more

cups

Milk can be fluid, whole, evap-
orated, skim, dry or buttermilk:
Cheese and ice cream may re-
place part of the milk; 1-inch
cube cheddar cheese = V2 cup
milk;

1/2 cup cottage cheese = V3 cup
milk;
\-U cup ice cream = 14 cup milk

Milk is the leading source of calcium needed for bones and teeth.
It also provides high quality protein, riboflavin, vitamin A and
many other nutrients.

VEGETABLE-FRUIT GROUP

Four or more servings

Include — a citrus or other fruit or vegetable; important for
vitamin C which is needed for healthy gums and body tissues.

Good source — grapefruit or
grapefruit juice ; orange or
orange juice; cantaloupe, guava,
mango, papaya, raw straw-
berries, broccoli, brussels
sprouts, green pepper, sweet red
pepper.

A dark green or deep yellow
vegetable for vitamin A — at
least every other day. Vitamin
A is needed for growth, normal
vision and healthy condition of
the skin. Dark green and deep
yellow vegetables and a few
fruits; namely, broccoli, canta-
loupe, carrots, chard, collards,
kale, mango, persimmons, pump-

kin, spinach, sweet potatoes,
turnip greens and other dark
green leaves.

Fair source — honey dew melon,
lemon, tangerine or tangerine
juice, watermelon, asparagus,
raw cabbage, collards, garden
cress, kale, mustard greens,
irish potatoes and sweet pota-
toes cooked in the jacket; toma-
toes and tomato juice; turnip
greens.

If the food chosen for vitamin (
is also a good source of vitamii
A, the additional serving of 1
vitamin A food may be omitted

184

FLORIDA HEALTH NOTES

The remaining 1 to 3 or more servings may be of any vegetable
r fruit. Fruits and vegetables are valuable because of the vitamins
nd minerals they contain. Count as 1 serving: Va cup of vegetable
r fruit ; or a portion as ordinarily served, such as 1 medium apple,
anana, orange or potato; half of a medium grapefruit or canta-
iiipe or the juice of 1 lemon.

BREAD-CEREAL GROUP
lour or more servings

Whole grain, enriched or re-
stored. This group includes:
breads, cooked cereals, ready-to-
eat cereals, cornmeal, crackers,
flour, grits, macaroni and spa-
ghetti, noodles, rice, rolled oats,
quick breads and other baked
poods if made with whole grain
or enriched flour.

Count as 1 serving: 1 slice of
bread, I ounce ready - to - eat
cereal, y% to % cup cooked
cereal, cornmeal, grits, macaro-
ni, noodles, rice or spaghetti. If
no cereals are chosen, add an ex-
tra serving of bread or baked
goods making 5 servings from
this group.

. . . make and operate
exhibit's for meetings
and conferences . . .

FLORIDA HEALTH NOTES

185

... set up displays for

photographic presen-
tations . . .

Food in this group furnishes worthwhile amounts of protein, iron,
several of the B-complex vitamins and food energy. (Unenriched
white breads, flour, grits do not provide the iron and B-complex
vitamins.)

OTHER FOODS

To round out meals and satisfy the appetite, people use some
foods not specified — butter, margarine, other fats, oils, sugars or
unenriched refined grain products. These are often ingredients in
baked goods and mixed dishes. Fats, oils and sugars are added to
food during preparation or at the table. These foods supply calories
and can add to total nutrient in meals. When there is need to re-
strict calories, these foods should be carefully limited.

With this guide most Floridians who have normal nutritional
needs could choose foods to keep them well. But there are people
with special health problems, or who, because of limited education
or income, need more help.

186

FLORIDA HEALTH NOTES

Changing Eating Habits

You may consider choosing, preparing and eating food a very
personal matter. You eat what you like, what you learned to eat
as a child, what you can afford to buy, and what you have the skill,
energy and kitchen facilities to prepare. Many people do not have
the knowledge to make the best choices, others may have the
knowledge but lack the motivation. Others have acquired the knowl-
edge and make a determined effort to do their best.

Nutritionists have found that giving nutrition information is
only part of their job. They must motivate people to change their
selection and preparation of foods. The nutritionist or public health
nurse must learn what the patient or family is eating, their cultural
background that might influence them to choose certain foods, the
money available to buy food and the facilities for storing and pre-
paring foods. They also need to know if the family grows vegeta-
bles in a garden, has a fruit tree, likes to fish, or can obtain surplus
commodity foods. The nutritionists begin by commending what is
good in the family's diet. Most people enjoy talking about them-
selves and nutritionists try to center the conversation on the
family's interests. As the nutritionists talk with the family, they
make suggestions for dietary improvements or modifications.
Teaching aids, posters, food models and printed materials are used
to reinforce the lessons. Diet charts with pictures of foods have
been prepared by the State Board of Health for persons who are
unable to read well.

i .
It :

Enrichment Laws

Florida does not have a flour and cereal enrichment law as do many
states, Florida manufacturers of flour, cereal, cornmeal and grits ore
not required to replace the iron, thiamine, riboflavin and niacin re-
moved in processing grain for refined flour. However, the Federal Gov-
ernment requires flour shipped interstate to be enriched with these
minerals and nutrients.

FLORIDA HEALTH NOTES • 187

... set up displays for
photographic presen-
tations . . .

Food in this group furnishes worthwhile amounts of protein, iron,
several of the B-complex vitamins and food energy. (Unenriched
white breads, flour, grits do not provide the iron and B-complex
vitamins.)

OTHER FOODS

To round out meals and satisfy the appetite, people use some
foods not specified — butter, margarine, other fats, oils, sugars or
unenriched refined grain products. These are often ingredients in
baked goods and mixed dishes. Fats, oils and sugars are added to
food during preparation or at the table. These foods supply calories
and can add to total nutrient in meals. When there is need to re-
strict calories, these foods should be carefully limited.

With this guide most Floridians who have normal nutritional
needs could choose foods to keep them well. But there are people
with special health problems, or who, because of limited education
or income, need more help.

186

FLORIDA HEALTH NOTES

'hanging Eating Habits

You may consider choosing, preparing and eating food a very
■ersonal matter. You eat what you like, what you learned to eat
s a child, what you can afford to buy, and what you have the skill,
energy and kitchen facilities to prepare. Many people do not have
he knowledge to make the best choices, others may have the
Knowledge but lack the motivation. Others have acquired the knowl-
edge and make a determined effort to do their best.

Nutritionists have found that giving nutrition information is
only part of their job. They must motivate people to change their
selection and preparation of foods. The nutritionist or public health
nurse must learn what the patient or family is eating, their cultural
background that might influence them to choose certain foods, the
money available to buy food and the facilities for storing and pre-
paring foods. They also need to know if the family grows vegeta-
bles in a garden, has a fruit tree, likes to fish, or can obtain surplus
commodity foods. The nutritionists begin by commending what is
good in the family's diet. Most people enjoy talking about them-
selves and nutritionists try to center the conversation on the
family's interests. As the nutritionists talk with the family, they
make suggestions for dietary improvements or modifications.
Teaching aids, posters, food models and printed materials are used
to reinforce the lessons. Diet charts with pictures of foods have
!>een prepared by the State Board of Health for persons who are
unable to read well.

Enrichment Laws

Florida does not have a flour and cereal enrichment law as do many
states. Florida manufacturers of flour, cereal, cornmeol and grits are
not required to replace the iron, thiamine, riboflavin and niacin re-
moved in processing grain for refined flour. However, the Federal Gov-
ernment requires flour shipped interstate to be enriched with these
minerals and nutrients.

FLORIDA HEALTH NOTES • 187

Diet Fads and Fallacies

Perhaps no area in health is more rampant with superstitions,
folklore and misleading 1 interpretations of new research findings
than nutrition and diet. It has been estimated that the American
public spends many millions of dollars each year on books with
misleading nutrition or health information, diet plans, "health
foods," nutrient supplements or reducing pills. Besides the great
waste of money, these unsound diet plans are a threat to health.
People have died or had their health damaged because they put
faith in an ineffective diet and ignored medical advice or did not
seek it soon enough. Quacks have claimed special health-giving
qualities for a wide variety of foods, including: honey and vinegar,
yogurt, blackstrap molasses, wheat germ, organically grown fruits
and vegetables and sea water. Nutritious foods, like milk, meat and
cereal products, have been condemned. Dietary cures have been
claimed for a myriad of diseases, including arthritis, cancer, dia-
betes, asthma, kidney stones and varicose veins.

Through educational programs, preparation of materials and
talks to lay and school groups, public health nutritionists inform
the public on the dangers of misleading dietary information.

Nutrition for Mothers and Babies

Nutritionists expend much time and effort on working with ex-
pectant mothers since pregnancy is a period of nutritional stress on
the mother. The food the mother eats provides the building ma-
terials for the new baby and influences his whole future, growth
and development.

Nutrition is considered important in the prevention of prema-
turity and mental retardation. A noted obstetrician recently told
Florida health workers that he considered nutrition the major
factor influencing the outcome of pregnancy. The nutritionists
either counsel mothers who attend County Health Department
clinics or provide necessary nutrition information to physicians,
nurses or midwives. Special attention is given to mothers who gain

188 • FLORIDA HEALTH NOTES

A PUBLIC HEALTH NUTRITIONIST

Requirements:
A bachelor's degree in food and nutrition or dietetics
A postgraduate degree in nutrition is advisable
Membership in the professional dietetic organization is desirable

The State Board of Health offers residency programs for college
graduates

Functions:

Applies knowledge of nutrition to public health programs for the
promotion of health, prevention of disease and treatment

Conducts or participates in educational programs for professional
staff of official and voluntary agencies

Designs, conducts and participates in dietary and nutrition studies
Prepares and evaluates dietary educational material
Cooperates with other agencies in nutrition programs for profes-
sional and lay groups

Works with;

Other public health personnel, teachers, school lunchroom personnel,
dentists, physicians

Individual patients, lay groups, schools and colleges

The State Board of Health and County Health Deportments have 21
nutritionists working throughout the state at the present time.

<

too much weight, have high blood pressure, have a nutritional
anemia, or some other complicated condition which may be cor-
rected by diet.

Mothers attending; clinics often enjoy group sessions and learn

' o change eating habits by sharing experiences with each other. A

nutritionist working in a Brevard County clinic was disappointed

it the lack of interest in the lesson she had prepared. At the next

linic she sat down in a corner and invited the women to join the

FLORIDA HEALTH NOTES

189

group only if they were interested in learning 1 what to eat to have
a healthy baby. The majority of the women responded and proved
to be a more receptive audience.

High quality maternity care in Florida is given impetus through
five new Maternity and Infant Care Projects serving 17 counties.
Each of these projects employs at least one full-time nutritionist
who under physicians' direction counsels and teaches mothers what
to eat during pregnancy and how to feed their infants.

. . , call on mothers
and children in their
homes (with a public
health nurse who is
not shown) to help
plan better diets . . .

Help for Children

Counseling on child feeding is one of the cornerstones of contin-
uous health supervision of infants and children. Insufficient
amounts of vitamins A and C, iron, protein and calcium are noted
in family meals and present a challenge to public health workers,
particularly when working with families with limited food budgets.
Many mothers need advice on how to start their children in develop-
ing good lifelong eating habits and overcoming eating problems.

190

FLORIDA HEALTH NOTES

Since obesity beginning in childhood may last into adult life,
t lildhood obesity should be prevented. Children with handicapped
conditions, such as cerebral palsy, cleft palate and diabetes, often
have special feeding problems with which nutritionists can help.

Additional research has linked inborn metabolic errors with
mental retardation. Phenylketonuria (PKU) is the best known ex-
ample. Through tests made by State Board of Health laboratories
during the first weeks of life, infants may be found with excessive

Teenagers and Foods

Teenagers are the most poorly nourished group among the popula-
tion. This is partly because of increased nutritional requirements
during their growing period and partly because of poor food choices.
Teenagers are so concerned about appearance, weight gain, skin con-
dition and social status that they are susceptible to dietary fads and
food binges. The food chokes of teenage girls are especially critical
because of their preparation for motherhood. The nutritional status of
a girl long before pregnancy can influence her future pregnancies and
the success of their outcome. This is true today for an increasing
number of girls are becoming mothers before they have achieved their
own adult growth.

amounts of phenylalanine, an essential component of protein, in
their blood. Diets prescribed by physicians can control this chemical
and prevent serious mental retardation. Nutritionists and public
health nurses spend considerable time teaching families to handle
these complicated diets.

As children giow, their needs for body building nutrients in-
crease. Nutritionists work with school health programs, with
county public health nurses visiting schools and with teachers and
school food service personnel to help children understand what
f >ods they should be eating and why.

Dental caries, particularly common among children, are related to
1 any aspects of diet, and nutritionists work with dentists and

FLORIDA HEALTH NOTES • 191

group only if they were interested in learning what to eat to have
a healthy baby. The majority of the women responded and proved
to be a more receptive audience.

High quality maternity care in Florida is given impetus through
five new Maternity and Infant Care Projects serving 17 counties.
Each of these projects employs at least one full-time nutritionist
who under physicians' direction counsels and teaches mothers what
to eat during pregnancy and how to feed their infants.

. . , coll on mothers
and children in their
homes (with a public
health nurse who is
not shown) to help
plan better diets . . .

Help for Children

Counseling on child feeding is one of the cornerstones of contin-
uous health supervision of infants and children. Insufficient
amounts of vitamins A and C, iron, protein and calcium are noted
in family meals and present a challenge to public health workers,
particularly when working with families with limited food budgets.
Many mothers need advice on how to start their children in develop-
ing good lifelong eating habits and overcoming eating problems.

190

FLORIDA HEALTH NOTES

1

Since obesity beginning in childhood may last into adult life,
, Jklhood obesity should be prevented. Children with handicapped
i .nditions, such as cerebral palsy, cleft palate and diabetes, often
1 ive special feeding problems with which nutritionists can help.

Additional research has linked inborn metabolic errors with
rental retardation. Phenylketonuria (PKU) is the best known ex-
ample, Through tests made by State Board of Health laboratories
curing the first weeks of life, infants may be found with excessive

Teenagers and Foods

Teenagers ore the most- poorly nourished group among the popula
t Hon. This is partly because of increased nutritional requirements I
f during their growing period and partly because of poor food choices.
Teenagers are so concerned about appearance, weight gain, skin con-

♦ dition and social status that they are susceptible to dietary fads and f
food binges. The food chokes of teenage girls are especially critical |
because of their preparation for motherhood. The nutritional status of

♦ o girl long before pregnancy can influence her future pregnancies and f
the success of their outcome. This is true today for an increasing
number of girls ore becoming mothers before they have achieved their .
own adult growth.

♦

amounts of phenylalanine, an essential component of protein, in
their blood. Diets prescribed by physicians can control this chemical
and prevent serious mental retardation. Nutritionists and public
health nurses spend considerable time teaching families to handle
those complicated diets.

As children giow, their needs for body building nutrients in-
i ease. Nutritionists work with school health programs, with
i unty public health nurses visiting schools and with teachers and
■ hool food service personnel to help children understand what

ods they should be eating and why.

Dental caries, particularly common among children, are related to
;my aspects of diet, and nutritionists work with dentists and

FLORIDA HEALTH NOTES • 191

»

A

. . . visit classrooms
with the public health
nurse to give lessons
in nutrition (above)
. . . plan school health
projects in nutrition
with the public health
nurse and teacher , . .

192

FLORIDA HEALTH NOTES

■

i

rental hygienists on nutrition and dental health. Nutrition educa-
t.on is incorporated into many aspects of school health, food service
and physical fitness programs.

Public health nutritionists frequently work with nutrition specia-
lists in other state agencies, such as the State Department of Edu-
cation and the State Department of Agriculture, in stimulating
youth groups to be interested in their own nutritional needs and
problems. A Youth Nutrition Conference is an example of this type
of cooperation.

Nutritionists guide food service personnel to plan menus for chil-
dren in Head Start programs, day care centers and residential and
group care facilities which are often on a limited food budget.

For the Chronically 111 and Aged

Florida, with its favorable climate, appeals to many older people
as a place to retire. Health workers are concerned about the nutri-
tional needs of these retired persons. Aging, in general, does not
change a person's nutritional needs except to decrease energy needs
because of the slowing down of bodily processes and the lessening
of physical activity. However, the nutritionist or public health
nurse may need to stress nutrition to older persons to maintain in-
terest in eating, to stimulate a lagging appetite and to provide
guidance in budgeting a limited retirement income. Without the
responsibility of cooking for a family, older persons often lack
imagination and incentive to cook nutritious meals for just one or
two.

Chronic illnesses may require the patient's physician to make
complicated diet changes. For example, for diabetics he may pre-
scribe a diet in terms of number of calories and amounts of carbo-
hydrates, protein and fat. To carry out this diet, most patients must
be taught food values and use of food exchange lists to maintain a
diet which will have variety and yet maintain a constant level of
caloric value.

Nutritionists

* counsel individuals with diabetes in diabetic clinics, general
ledical clinics or when referred by private physicians;

FLORIDA HEALTH NOTES • 193

, . . visit classrooms
with the public health
nurse to give lessons
in nutrition 'above 1
. . . plan school health
projects in nutrition
with the public health
nurse and teacher . .

192

FLORIDA HEALTH NOTES

ft

( >ntal hygienists on nutrition and dental health. Nutrition educa-
t m is incorporated into many aspects of school health, food service
; id physical fitness programs.

Public health nutritionists frequently work with nutrition specia-
lists in other state agencies, such as the State Department of Edu-
cation and the State Department of Agriculture, in stimulating
youth groups to be interested in their own nutritional needs and
problems. A Youth Nutrition Conference is an example of this type
of cooperation.

Nutritionists guide food service personnel to plan menus for chil-
dren in Head Start programs, day care centers and residential and
group care facilities which are often on a limited food budget.

For the Chronically 111 and Aged

Florida, with its favorable climate, appeals to many older people
as a place to retire. Health workers are concerned about the nutri-
tional needs of these retired persons. Aging, in general, does not
change a person's nutritional needs except to decrease energy needs
because of the slowing down of bodily processes and the lessening
of physical activity. However, the nutritionist or public health
nurse may need to stress nutrition to older persons to maintain in-
terest in eating, to stimulate a lagging appetite and to provide
guidance in budgeting a limited retirement income. Without the
responsibility of cooking for a family, older persons often lack
imagination and incentive to cook nutritious meals for just one or
two.

Chronic illnesses may require the patient's physician to make
complicated diet changes. For example, for diabetics he may pre-
M-ribe a diet in terms of number of calories and amounts of carbo-
hydrates, protein and fat. To carry out this diet, most patients must
: e taught food values and use of food exchange lists to maintain a

iet which will have variety and yet maintain a constant level of

aloric value.

utritionists

• counsel individuals with diabetes in diabetic clinics, general
ledical clinics or when referred by private physicians;

FLORIDA HEALTH NOTES • 193

• with the aid of public health nurses, conduct classes of persons
with diabetes;

• provide dietary information to public health nurses who in-
struct diabetic patients in their homes; and

• speak at meetings of lay diabetes associations.

Nutritionists assist patients with heart condition who may re-
quire a diet controlled in fat, restricted in sodium, or designed for
weight reduction. There are many other chronic conditions for
which physicians prescribe diet therapy such as liver or gallbladder
disorders, digestive problems, weight control and endocrine dis-
turbances. Nutritionists counsel these patients directly or provide
guidance in conferences with public health nurses on needs of in-
dividual patients or in-service programs on therapeutic dietetics.

Medicare and home health services have focused attention on
nutrition for the chronically ill and aging. Nutritionists train home
health aides in nutrition and food management and they serve as
consultants to these aides as they undertake responsibility for
serving foods to patients.

Two institutional nutrition consultants provide leadership to
State Board of Health nutritionists who assist small hospitals and
nursing homes with planning nutritionally adequate meals, provid-
ing therapeutic diets as ordered by physicians, and training staffs
in proper methods of food handling and preparation.

Hospitals and extended care facilities must employ a qualified
dietitian, at least on a part-time or consultant basis, to be certified
for Medicare. With the majority of small hospitals and nursing
homes In Florida not now employing a full-time dietitian, nutrition-
ists are recruiting dietitians who can give part-time service to in-
stitutions, and providing them with refresher courses, consultation
and educational material.

Nutritional Services for Low Income Groups

Because limited financial resources make purchasing food, ade-
quate housing and adequate health care more difficult, a major
portion of public health programs are directed to people with low
incomes. Many of these people are further handicapped by little

194 • FLORIDA HEALTH NOTES

. . . and teach a class for
home health aides at a
Visiting Nurse Association
headquarters.

education. Guidance is given by nutritionists in planning meals
around less expensive but nutritious foods, improving buying prac-
tices and preparing foods.

In 25 Florida counties, surplus commodity foods available through
the State Department of Public Welfare, are distributed to eligible
families. Nutritionists work with extension home economists and
interested health workers to assist families in using these foods in
meals. Demonstrations and "tasting parties" at the distribution
centers or clinics have been conducted in several counties.

1*1

Migrant workers receive the attention of a nutritionist who is
ssigned to the migrant health project. The nutritional needs of
hese workers are complicated by make-shift homes, poor cooking
acilities, erratic incomes, irregular working hours and limited

FLORIDA HEALTH NOTES

195

• with the aid of public health nurses, conduct classes of persons
with diabetes;

• provide dietary information to public health nurses who in-
struct dialtetk patients in their homes; and

• speak at meetings of lay diabetes associations.

Nutritionists assist patients with heart condition who may re-
quire a diet controlled in fat, restricted in sodium, or designed for
weight reduction. There are many other chronic conditions for
which physicians prescribe diet therapy such as liver or gallbladder
disorders, digestive problems, weight control and endocrine dis-
turbances. Nutritionists counsel these patients directly or provide
guidance in conferences with public health nurses on needs of in-
dividual patients or in-service programs on therapeutic dietetics.

Medicare and home health services have focused attention on
nutrition for the chronically ill and aging. Nutritionists train home
health aides in nutrition and food management and they serve as
consultants to these aides as they undertake responsibility for
serving foods to patients.

Two institutional nutrition consultants provide leadership to
State Board of Health nutritionists who assist small hospitals and
nursing homes with planning nutritionally adequate meals, provid-
ing therapeutic diets as ordered by physicians, and training staffs
in proper methods of food handling and preparation.

Hospitals and extended care facilities must employ a qualified
dietitian, at least on a part-time or consultant basis, to be certified
for Medicare. With the majority of small hospitals and nursing
homes in Florida not now employing a full-time dietitian, nutrition-
ists are recruiting dietitians who can give part-time service to in-
stitutions, and providing them with refresher courses, consultation
and educational material.

Nutritional Services for Low Income Groups

Because limited financial resources make purchasing food, ade-
quate housing and adequate health care more difficult, a majoi
portion of public health programs are directed to people with low
incomes. Many of these people are further handicapped by little

194 • FLORIDA HEALTH NOTES

. . . and teach a class for
home health aides at a
Visiting Nurse Association
headquarters.

education. Guidance is given by nutritionists in planning meals
mound less expensive but nutritious foods, improving buying prac-
tices and preparing foods.

in 25 Florida counties, surplus commodity foods available through
' he State Department of Public Welfare, are distributed to eligible
amilies. Nutritionists work with extension home economists and
uterested health workers to assist families in using these foods in
neals. Demonstrations and "tasting parties" at the distribution
enters or clinics have been conducted in several counties.

Migrant workers receive the attention of a nutritionist who is
>signed to the migrant health project. The nutritional needs of
■lese workers are complicated by make-shift homes, jxjor cooking
icilities, erratic incomes, irregular working hours and limited

FLORIDA HEALTH NOTES

195

homemaking skills. These families need health programs brought to
them at their convenience and because of their lack of education,
nutrition teaching becomes very simple and basic.

The Nutritionists and You

Many Floridians may never meet a nutrition consultant. Perhaps
their children may hear a nutritionist speak to a school group or see
her visit a classroom. Some Florida residents may hear a nutrition-
ist speak at a community meeting or read an article she has pre-
pared for their local newspaper.

Healthy Floridians may never need the services of a nutritionist.
If they eat adequate amounts of the four groups, as recommended
in the section on "The Foods to Eat," they will have a nutritious

r

VA*

Films and Pamphlets

A few of the motion pictures on nutrition available from the Audio-
Visual Library, Florida State Board of Health, P. 0. Box 210, Jack-
sonville, Florida 32201, are listed below:

The Best Way to Eat — the importance of nutrition based on scien-
tific knowledge.

Food the Color of Life — general information on nutrition.
Four Food Groups — the preparation of a balanced diet from the
four food groups.

Human Body: Nutrition and Metabolism — the relation between
nutrition and metabolism and their bearing upon the caloric intake of
the body.

Nutrition Sense and Nonsense — information on food quackery.
More than Food — nutrition in nursing homes.

Some of the pamphlets also available from the Division of Health
Education, Florida State Board of Health, at the above address are:

What Everyone Should Know About Obesity

The Healthy Way to Weigh Less

Eat and Enjoy It

Food Your Children Need

196 • FLORIDA HEALTH NOTES

~*5i

The institutional nu-
trition consultant ob-
serves the routine in a
nursing home kitchen
'above) and then dis
c isses the preparation
of the meals with the
; aft so that patients
r ay receive more nu-
■ irious diets.

A
i

homemaking skills. These families need health programs brought to
them at their convenience and because of their lack of education,
nutrition teaching becomes very simple and basic.

The Nutritionists and You

Many Floridians may never meet a nutrition consultant. Perhaps
their children may hear a nutritionist speak to a school group or see
her visit a classroom. Some Florida residents may hear a nutrition-
ist speak at a community meeting or read an article she has pre-
pared for their local newspaper.

Healthy Floridians may never need the services of a nutritionist.
If they eat adequate amounts of the four groups, as recommended
in the section on "The Foods to Eat," they will have a nutritious

r

.-

Films and Pamphlets

A few of the motion pictures on nutrition available from the Audio-
Visual Library, Florida State Board of Health, P. 0. Box 210, Jack-
sonville, Florida 32201, are fisted below:

The Best Way to Eat — the importance of nutrition based on scien-
tific knowledge.

Food the Cofor of Life — general information on nutrition.

Four Food Groups — the preparation of a balanced diet from the
four food groups.

Human Body: Nutrition and Metabolism — the relation between
nutrition and metabolism and their bearing upon the caloric intake cf
the body.

Nutrition Sense and Nonsense — information on food quackery.

More than Food — nutrition in nursing homes.

Some of the pamphlets also available from the Division of Health
Education, Florida State Board of Health, at the above address are:

What Everyone Should Know About Obesity

The Healthy Way to Weigh Less

Eat and Enjoy It

Food Your Children Need

196 • FLORIDA HEALTH NOTES

The institutional nu-
i ition consultant ob-
i rves the routine in a
i irsing home kitchen

iboveJ and then dis-

< sses the preparation

the meals with the

! iff so that patients

' jy receive more nu-

tious diets.

r

*ȣ"*

w Zr t \ *«*:

diet If you have a question about nutrition or about a diet pre-
scribed by your family physician, contact your County Health De-
partment. Nutrition consultants have offices in Dade, Hillsborough,
Palm Beach, Marion, Seminole, Highlands and Levy Counties, the
State Board of Health's regional office in Tallahassee, and the
Division of Nutrition at the State Board of Health's headquarters
in Jacksonville.

Staff members of the State Board of Health and the Pinellas County Health
Department participate in a Teen Quackery Jamboree which is sponsored
annually by the Pinellas County Nutrition Committee. Skits, such as "Quack
Pots," are included in the program.

198

FLORIDA HEALTH NOTES

■JS*.*******"" ~

FCDf* \ DA ; STATE . USftAfttf

diet. If you have a question about nutrition or about a diet pre-
scribed liy your family physician, contact your County Health De-
partment. Nutrition consultants have offices in Dade. Hillsboroupn,
Palm Beach, Marion, Seminole, Highlands and Levy Counties, the
State Board of Health's regional office in Tallahassee, and the
Division of Nutrition at the State Board of Health's headquarters
in Jacksonville.

I

Staff members of the State Board of Heoith and the Pinellas County Heoith
Department participate in a Teen Quockery Jamboree which is sponsored
annually by the Pinellas County Nutrition Committee. Skits, such as "Quack
Pots," are included in the program.

198

FLORIDA HEALTH NOTES

ri

FLORIDA

HEALTH

NOTES

(Cover photo) The co-
ordinated team of every
County Health Depart-
ment includes the sani-
tarian, public health
nurse and clerk.

/Over 1600 Public Health Nurses, Sanitarians
I and Clerks are engaged in protecting your
V health in our 67 County Health

^s. Departments.

\5

PROFILES

Clerk

Public Health
Nurse

Sanitarian

"My baby needs shots. Where can we get them ? We can't afford
a doctor."

"What can I do about our neighbor's garbage?"

"Where do I get a health card ?"

"What can I do? I've been bitten by a dog."

"What immunizations do I need to go abroad?"

"I have a child in my class who needs medical attention. When
can you see him?"

"I'm going to have a baby. What do I do."

"Where can I find out everything about health? 1 '

Questions similar to these are asked all the time in Florida.
There are people in every County Health Department who know
most of the answers. They are the ones who carry on public health

i

FLORIDA HEALTH NOTES • 203

programs at the local level. They are the clerk, public health nurse
and sanitarian.

The clerk is the public health worker most of the public meets
first — either by telephone or in the office. She does mountains of
paper work to keep the County Health Department operating
smoothly and satisfactorily; she makes out reports, does the filing
and orders supplies.

The public health nurse is a professional who, among other
duties, provides nursing service to the community, operates the
clinics and acts as liaison between schools, homes and the com-
munity.

The sanitarian is the member of the staff who is responsible for
carrying out health rules and regulations, for promoting a health y
environment, for conducting investigations and surveys, and for
supervising sanitary practices relating to many conditions, places
and establishments.

Each of these persons is an important member of the County
Health Department team. The team also includes the county health
director whose duties were discussed in the May 1966 issue of
Florida Health Notes. This issue will tell you a little about the
work of some of the other members of the County Health Depart-
ment staff and how they carry out their responsibilities.

We cannot possibly include every detail of the work of the clerk,
public health nurse and sanitarian because the work is carried out
a little differently in every county— according to the needs of the
county as the health director and his staff see them, the "person-

FLOftlDA HEALTH NOTES

Published monthly bv the Florida State Board of Health, Wilson T. Sawder, M.D., M.P.H..
Slots Health Officer. Publication office. Box 210. Jacksonville. Fiondo 32201. Second class
poil age paid at Jacksonville, Florida This publication is lor individuals and institutions with
an interest in the state's health programs Permission is given to quote any story providing
credit is given to the Florida State Board of Health. Ed. tor: Robert A. Schoonover, MA.
Divrsion of Health Education.

VOLUME 5° — NO. 4

204 • FLORIDA HEALTH NOTES

APRIL 1967

ality" of each county, the policies and procedures of each County
Health Department, and the attributes of each individual on the
staff.

We cannot say one public health worker is more important than
the others ; so we are discussing them in alphabetical order — clerk,
public health nurse and sanitarian. These people, while discussed
separately, do not work separately but as a coordinated health team.

The County Health Department

Chapter 154 of the Florida Statutes notes that full-time health
units shall have a director, public health nurse, sanitary officer and
a clerk, who are especially trained in public health administration
and practices as related to the duties of their position. These people
are to be employed by the Board of County Commissioners, ap-
proved by the State Board of Health and certified by the Florida
Merit System.

There are 42 county health units in Florida's 67 counties.
Twenty-five of these are single county units. Some of the counties
are so small that they have only a clerk and a public health nurse
but share their sanitarian and county health director with one
or two other counties. Thus, there are nine bi-county units and
eight tri-county units.

Some of the larger County Health Departments may have as
many as 450 employees, including such professional people as
physicians, dentists, health educators, administrators, nutritionists,
sanitary engineers and laboratory technicians. We know these
people are also important to the functions of the County Health De-
partment but we will not be discussing their work in this issue of
Florida Health Notes.

Since many of the County Health Departments have moved from
the basement of the county court house or the second floor of an
annex, their images have improved in the minds of many county
residents. Some people wouldn't go to the County Health Depart-
ment because of such things as poor facilities in dark recesses of
a business building or the lack of parking space. But new buildings
have created new interests in public health and more people are

FLORIDA HEALTH NOTES • 205

i
i

finding their way to the doors of the County Health Department.
Not all departments have moved for some have had good quarters
for a number of years while others are still waiting for new and
better facilities.

Because public health workers know the people of their com-
munities as well as anyone else, they are often called upon to serve
on health or nursing councils. They are frequently leaders in their
community, especially in the smaller counties, and active members
of lodges, civic groups and churches. Sanitarians often are sought
out for advice by other community groups. Public health nurses are
usually active in local nursing associations and serve on health and
welfare committees of civic and voluntary health organizations.

The clerk, who may
also serve as recep-
tionist, is frequently
the first member of
the health team the
public meets.

II

THE CLERK

Whether she is a receptionist or a clerk in a large County Health
Department or the only clerical person in a small County Health
Department, the clerk is frequently the first person the public
meets. She is the "information bureau" for the county. People
come to her for information about health, Social Security, Medicare,
welfare and other state agencies.

In the small county she needs to know where "Grandma Blake"
lives, who occupies the blue house in the next block and how to give
directions. This may not necessarily be true in the larger county,
but she needs to be able to give directions to the welfare or some
other governmental office or to any of the voluntary health agen-
cies.

She may have a high school, a business college or a college educa-
tion, but she is important because she has to know all about the
nursing and sanitation programs of the County Health Department
and explain their functions to the public. The clerk has to know
how to handle various types of people:

an angry mother who wants her son immunized "right now" ;

a little old lady who comes in on a wrong clinic day ; or

the big, burly man who doesn't read the sign, FAMILY PLAN-
NING CLINIC, picks up a number and waits his turn — not under-
standing that he is in line for the wrong clinic.

The clerk has to understand people with limited educations who
really don't know what they need and others who communicate
poorly.

Forty of the 67 County Health Departments have only one or
two clerks while 14 counties have more than 10. In many of the
smaller counties much of the administrative work is up to the
clerks, because the county health director is shared by other County
Health Departments and he is in the office only one or two days a
week. These are usually clinic days and there is much for the
director to do.

FLORIDA HEALTH NOTES • 207

finding their way to the doors of the County Health Department.
Not all departments have mo%-ed for some have had (rood quarters
for a number of years while others are still wailing for new and
better facilities.

Because public health workers know the people of their com-
munities as well as anyone else, they are often called upon to serve
on health or nursing councils. They are frequently leaders in their
community, especially in the smaller counties, and active members
of lodges, civic groups and churches. Sanitarians often are sought
out for advice by other community groups. Public health nurses are
usually active in local musing associations and serve on health and
welfare committees of civic and voluntary health organizations.

The clerk, who may
also serve as recep-
tionist, is frequently
the first member of
the health team the
public meets.

THE CLERK

Whether she is a receptionist or a clerk in a large County Health
Department or the only clerical person in a small County Health
Department, the clerk is frequently the first person the public
meets. She is the "information bureau" for the county. People
come to her for information about health. Social Security, Medicare,
welfare and other state agencies.

In the small county she needs to know where "Grandma Blake"
lives, who occupies the blue house in the next block and how to give
directions. This may not necessarily be true in the larger county,
but she needs to be able to give directions to the welfare or some
other governmental office or to any of the voluntary health agen-
cies.

She may have a high school, a business college or a college educa-
tion, but she is important because she has to know all about the
nursing and sanitation programs of the County Health Department
and explain their functions to the public. The clerk has to know
how to handle various types of people:

an angry mother who wants her son immunized "right now";

a little old lady who comes in em a wrong clinic day ; or

the big, burly man who doesn't read the sign, FAMILY PLAN-
NING CLINIC, picks up a number and waits his turn — not under-
standing that he is in line for the wrong clinic.

The clerk has to understand |>eople with limited educations who
really don't know what they mei\ and others who communicate
poorly.

Forty of the 67 County Health Departments have only one or
two clerks while 14 counties have more than 10. In many of the
smaller counties much of the administrative work is up to the
clerks, because the county health director is shared by other County
Health Departments and he is in the office only one or two days a
week. These are usually clinic days and there is much for the
director to do.

FLORIDA HEALTH NOTES • 207

A Myriad of Duties

Mrs. L is the only full-time clerk in a small County Health De-
partment. She has to work closely with the rest of the public health
team in her county. She answers the telephone, takes messages
for the staff, and because she must make appointments for the
county health director, public health nurse and sanitarian, she needs
to know where they are most of the time and when they will be
back to the office.

She types letters, reports and payrolls ; keeps the sick and annual
leave records and personnel files of all employees up to date. She
sets up patient records for clinics. One of her most important
duties is to keep records of the County Health Department con-
fidential. Without the proper keeping and filing of records, the
operation of the department would be disrupted.

When the county health director is in the office only one or two
days> of the week, Mrs. L must of necessity handle much of the
correspondence, travel reports and inquiries which cannot be routed
to the sanitarian or public health nurse. During those days when
the county health director is holding clinics, Mrs. L must have the

New business mach-
ines, such as photo-
copiers, have made
the work of the clerk
much easier,

208

files on each patient ready for the time when he will see the phy-
sician ; she codes the visit and files the folder in its proper place.

As in many County Health Departments, Mrs. L is responsible
for more than just the managing of the office. Frequently her
advice is sought by the county health director on many different
subjects. She keeps the financial records and helps make up the
annual budget and financial reports which go to the State Board
of Health and the Board of County Commissioners.

Because she is the only clerk in the County Health Department,
Mrs. L has to do all the work that is handled by clerical specialists
in larger counties. She is the Deputy Registrar of Vital Statistics
and checks birth and death certificates. Many times she is called
during the night to issue a burial-removal permit so a funeral di-
rector can take a body from a hospital.

Mrs. L has to have all of the information for international travel
at her fingertips; she alphabetizes and files laboratory reports,
types the orders for drugs and supplies and refers inquiries from
the local press to proper sources when her county health director is
not at the office. Mrs. L has to supervise the custodian and some-
times sees to the upkeep of the County Health Department grounds
and buildings.

Keeping the records and files of the various hospitalization and
indigent programs in order is an important part of Mrs, L's work.
She makes out applications to send cancer patients to the hospital,
calls the hospital for an appointment and sees that the necessary
follow-up paperwork is handled properly. Such programs as Hospi-
tal Services for the Indigent, Medicare and Maternal and Infant
Care require mountains of paperwork and correspondence.

Because of the intricacies of her duties, Mrs. L must know some-
thing about organizational setup and policies of the State Board of
Health and be familiar with the various health laws passed by the
State Legislature.

Specialization in the Larger County

The clerical staff of a large County Health Department may have
a number of clerks who work in various offices and do specialized

FLORIDA HEALTH NOTES • 209

A Myriad of Duties

Mrs. L is the only full-time clerk in a small County Health De-
partment. She has to work closely with the rest of the public health
team in her county. She answers the telephone, takes messages
for the staff, and because she must make appointments for the
county health director, public health nurse and sanitarian, she needs
to know where they are most of the time and when they will be
back to the office.

She types letters, reports and payrolls; keeps the sick and annual
leave records and personnel files of all employees up to date. She
sets up patient records for clinics. One of her most important
duties is to keep records of the County Health Department con-
fidential. Without the proper keeping and filing of records, the
operation of the department would be disrupted.

When the county health director is in the office only one or two
day* of the week, Mrs. L must of necessity handle much of the
correspondence, travel re])orts and inquiries which cannot be routed
to the sanitarian or public health nurse. During those days when
the county health director is holding clinics, Mrs. L must have the

New business mach-
ines, such as photo-
copiers, have mode
the work of the clerk
much easier.

208

files on each patient ready for the time when he will see the phy-
sician ; she codes the visit and files the folder in its proper place.

As in many County Health Departments, Mrs, L is responsible
for more than just the managing of the office. Frequently her
advice is sought by the county health director on many different
subjects. She keeps the financial records and helps make up the
annual budget and financial reports which go to the State Board
of Health and the Board of County Commissioners.

Because she is the only clerk in the County Health Department,
Mrs. L has to do all the work that is handled by clerical specialists
in larger counties. She is the Deputy Registrar of Vital Statistics
and checks birth and death certificates. Many times she is called
during the night to issue a burial-removal permit so a funeral di-
rector can take a body from a hospital

Mrs. L has to have all of the information for international travel
at her fingertips; she alphabetizes and files laboratory reports,
types the orders for drugs and supplies and refers inquiries from
the local press to proper sources when her county health director is
not at the office. Mrs. L has to supervise the custodian and some-
times sees to the upkeep of the County Health Department grounds
and buildings.

Keeping the records and files of the various hospitalization and
indigent programs in order is an important part of Mrs. L's work.
She makes out applications to ^end cancer patients to the hospital,
calls the hospital for an appointment and sees that the necessary
follow-up paperwork is handled properly. Such programs as Hospi-
tal Services for the Indigent, Medicare and Maternal and Infant
Care require mountains of paperwork and correspondence.

Because of the intricacies of her duties. Mrs. L must know some-
thing about organizational setup and policies of the State Board of
Health and be familiar with the various health laws passed by the
State Legislature.

Specialization in the Larger County

The clerical staff of a large County Health Department may have
a number of clerks who work in various offices and do specialized

FLORIDA HEALTH NOTES • 209

work. They may work in vital statistics, the tuberculosis control
office, at the switchboard, in the reception area or as private secre-
taries or administrative assistants.

In one large County Health Department, new clerks are given
a two-week orientation prior to starting their work. They spend a
day in each of the various departments and one of the health cen-
ters. They are informed about the major rules and duties of the
County Health Department, general information, including con-
duct and dress, and such fringe benefits as vacation, hospitaliza-
tion, insurance and retirement. Following a successful six-month
probation period, they are given permanent status.

In the larger departments, clerical staff meetings may be held
once a month. These are combination meetings which feature a
business and an educational period to work out problems concerning
the staff and an educational period where the clerks learn about
good telephone mariners, proper dress for the office and new health
programs.

The Clerks' Manual

The procedure for much of the clerks' work is often set down in
a clerical handbook which tells the proper way to type letters and
memoranda and fill out various types of activity reports. Much of
this information is important to the clerks who process 500 or more
health cards a week or to the clerk who is substituting in a tumor
clinic for a fellow employee. The book tells who should receive
birth and death certificates, the procedure in handling venereal
disease patients and the names of important people in the County
Health Department, local government and community. New busi-
ness machines have made the work of the clerks easier and added to
the efficiency of the County Health Department.

A good clerk screens the miscellaneous information seekers from
the members of the staff; knows where the resources of the com-
munity are located; takes care of a multitude of minor details of
the County Health Department work ; and relieves the director and
staff of the problem of answering unnecessary questions from the
public.

The clerk is also the important member of the team who keeps
communication channels open between the people of the community

210

FLORIDA HEALTH NOTES

Keeping records and
bookkeeping are im-
portant parts of the
clerk's duties.

and the rest of the County Health Department team. She may help
the indigent patient fill out forms for hospitalization, or help an
individual find out abaut welfare payments.

THE PUBLIC HEALTH NURSE

The aim of public health nursing in Florida is to give quality
nursing service to the entire community. When the public health
nurse sees a new mother and her baby in their home, inspects a
preschool child who may have health problems, talks to an ex-
pectant mother who needs health information, interviews an adult
who has contracted venereal disease, or visits an elderly person who
has diabetes, she wishes to render the best service to all of these
people.

The public health nurse is a registered professional nurse, a
graduate of a three-year diploma school or a degree graduate of a
college or university. If she has had no public health education or
experience, the nurse receives a planned orientation. In larger
counties the orientation is given by the County Health Department,

Field training centers, to orient nurses from smaller counties to
public health nursing, have been established in Clay, Orange, Palm
Beach and Polk County Health Departments. This intensive pro-
gram lasts for eight weeks. Regardless of the size of the county,
all orientees receive an orientation which follows the guide de-
veloped by the Continuing Education Committee of the State Board

FLORIDA HEALTH NOTES

211

work. They may work in vital statistics, the tuberculosis control
office, at the switchboard, in the reception area or as private secre-
taries or administrative assistants.

In one large County Health Department, new clerks are given
a two- week orientation prior to starting their work. They spend a
day in each of the various departments and one of the health cen-
ters. They are informed about the major rules and duties of the
County Health Department, general information, including con-
duct and dress, and such fringe benefits as vacation, hospitaliza-
tion, insurance and retirement. Following a successful six-month
probation period, they are given permanent status.

In the larger departments, clerical staff meetings may be held
once a month. These are combination meetings which feature a
business and an educational period to work out problems concerning
the staff and an educational period where the clerks learn about
good telephone manners, proper dress for the office and new health
programs.

The Clerks' Manual

The procedure for much of the clerks' work is often set down in
a clerical handbook which tells the proper way to type letters and
memoranda and fill out various types of activity reports. Much of
this information is important to the clerks who process 500 or more
health cards a week or to the clerk who is substituting in a tumor
clinic for a fellow employee. The book tells who should receive
birth and death certificates, the procedure in handling venereal
disease patients and the names of important people in the County
Health Department, local government and community. New busi-
ness machines have made the work of the clerks easier and added to
the efficiency of the County Health Department.

A good clerk screens the miscellaneous information seekers from
the members of the staff; knows where the resources of the com-
munity are located; takes care of a multitude of minor details of
the County Health Department work ; and relieves the director and
staff of the problem of answering unnecessary cpuestions from the
public.

The clerk is also the important member of the team who keeps
communication channels open between the people of the community

210

FLORIDA HEALTH NOTES

t ! Keeping records and
bookkeeping are im-
portant parts of the
clerk's duties.

and the rest of the County Health Department team. She may help
the indigent patient fill out forms for hospitalization, or help an
individual find out ab3ut welfare payments.

THE PUBLIC HEALTH NURSE

The aim of public health nursing in Florida is to give quality
nursing service to the entire community. When the public health
nurse sees a new mother and her baby in their home, inspects a
preschool child who may have health problems, talks to an ex-
pectant mother who needs health information, interviews an adult
who has contracted venereal disease, or visits an elderly |>erson who
has diabetes, she wishes to render the best service to all of these
people.

The public health nurse is a registered professional nurse, a
graduate of a three-year diploma school or a degree graduate of a
college or university. If she has had no public health education or
experience, the nurse receives a planned orientation. In larger
counties the orientation is given by the County Health Department.

Field training centers, to orient nurses from smaller counties to
public health nursing, have been established in Clay, Orange, Palm
Beach and Polk County Health Departments. This intensive pro-
gram lasts for eight weeks. Regardless of the size of the county,
all mientees receive an orientation which follows the guide de-
veloped by the Continuing Education Committee of the State Board

FLORIDA HEALTH NOTES

211

>

¥

\

i>

Home nursing ser-
vice is an important
port of the public
health nurse's work.

of Health, Division of Public Health Nursing. Included in the
orientation are theory, observation and practice in public health
nursing.

In the Small Counties

While 14 of the County Health Departments have more than 10
nurses (one has 160), 44 of the 67 counties have five or less public
health nurses.

Mrs. G, one of two public health nurses in a small county, has in
her caseload a hundred or more families whom she visits in the
home. She also provides nursing service to schools, gives nursing
service in clinics and to persons who come into the Health Depart-
ment.

212

FLORIDA HEALTH NOTES

I

The families may have from one to nine individuals to whom she
gives services:

the pregnant woman,

the newborn baby and his mother,

the children of all ages with their myriad of problems, such as a
congenital defect, hearing, weight or emotional problems,

the father with a heart defect, and

the diabetic grandparent who needs home health services.

When Mrs. G plans her visits for the day she uses her profes-
sional knowledge and sets priorities for the visits. She uses safe
nursing techniques which prevent her transmitting infection from
one family to another.

• She visits a mother and her newborn first thing in the morn-
ing. She undresses and inspects the baby for .malformations or
other conditions. At the same time, Mrs. G talks to the mother
about her feelings toward the baby and instructs her in the baby's
care and what to expect in the growth and development of the in-
fant. Also, she will evaluate the mother's physical and emotional
status.

• From this visit, Mrs. G goes to the home of a schoolchild to
discuss with the parents the necessity for completing immuniza-
tions or to refer the child for dental or medical care. About 60 per
cent of Florida's schoolchildren need dental care while 20 per cent
need hearing or vision correction. The nurse is often able to help
the family plan to meet the needs or to find necessary assistance.

• Mrs. G then goes to one of the schools in her county. On this
visit she will contact the school health coordinator or principal to
learn if there are any special problems. The visit may be for one
or many reasons, some of which are: to help with physical
examinations given by a physician ; to test the vision or hearing of
children in a selected grade; to teach infant care to a home
economics or first aid class ; or to discuss with a classroom teacher
the health, physical and mental status of each student in the room.

FLORIDA HEALTH NOTES • 213

I*

\

r

{

u

\

1>

Home nursing ser-
vice is on important
part of the public
health nurse's work.

of Health, Division of Public Health Nursing. Included in the
orientation are theory, observation and practice in public health
nursing.

In the Small Counties

While 14 of the County Health Departments have more than 10
nurses (one has 160), 44 of the 67 counties have five or less public-
health nurses.

Mrs. G, one of two public health nurses in a small county, has in
her caseload ;t hundred or more families whom she visits in the
home. She also provides nursing service to schools, gives nursing
service in clinics and to persons who come into the Health Depart-
ment.

212

FLORIDA HEALTH NOTES

F

The families may have from one to nine individuals to whom she
gives services :

the pregnant woman,

the newborn baby and his mother,

the children of all ages with their myriad of problems, such as a
congenital defect, hearing, weight or emotional problems,

the father with a heart defect, and

the diabetic grandparent who needs home health services.

When Mrs. G plans her visits for the day she uses her profes-
sional knowledge and sets priorities for the visits. She uses safe
nursing techniques which prevent her transmitting infection from
one family to another.

• She visits a mother and her newborn first thing in the morn-
ing. She undresses and inspects the baby for .malformations or
other conditions. At the same time, Mrs. G talks to the mother
about her feelings toward the baby and instructs her in the baby's
care and what to expect in the growth and development of the in-
fant. Also, she will evaluate the mother's physical and emotional
status.

• From this visit, Mrs. G goes to the home of a schoolchild to
discuss with the parents the necessity for completing immuniza-
tions or to refer the child for dental or medical care. About 60 per
cent of Florida's schoolchildren need dental care while 20 per cent
need hearing or vision correction. The nurse is often able to help
the family plan to meet the needs or to find necessary assistance.

• Mrs. G then goes to one of the schools in her county. On this
visit she will contact the school health coordinator or principal to
learn if there are any special problems. The visit may be for one
or many reasons, some of which are: to help with physical
examinations given by a physician ; to test the vision or hearing of
children in a selected grade; to teach infant care to a home
economics or first aid class ; or to discuss with a classroom teacher
the health, physical and mental status of each student in the room.

FLORIDA HEALTH NOTES • 213

« — -

The public health nurse gives a talk on health during a visit to a
school.

The nurse serves as liaison between the teacher and the child's
parents where health problems are slowing the child's progress.

Mrs. G's visits for the day may include an elderly diabetic woman
with an infected foot, who is receiving service under Medicare. She
will change the dressing while determining if the patient's food
habits should be altered, and/or discuss with the patient other
health problems.

• She also visits a 40-year-old father who has had a heart attack.
Following the physician's plan of treatment, Mrs. G may bathe the
patient, give an injection, and discuss with the wife a low sodium
diet.

When performing any of the above nursing services, Mrs. G is
using her professional knowledge and drawing on the information

214

FLORIDA HEALTH NOTES

she receives from conferences, inservice education, seminars and
other educational activities.

Clinical Services

As one of the two nurses in the county, Mrs. G works with the
county health director in the clinics. On the first and third Thurs-
day of the month, there are prenatal clinics. In some counties there
are maternal and infant care high-risk clinics where women who
may have complications during pregnancy and delivery of their
babies are given special attention.

On the second and fourth Thursday of the month, there are well-
baby clinics where infants are examined for growth and develop-
ment, weighed and given immunizations. In the postpartum period,
mothers are examined, their blood pressures and temperatures are
taken, and any problems they may have with the infants are dis-
cussed with the county health director and the public health nurse.
Family planning may also be diseussed.

General clinics are held once a week and Mrs. G and the director
see all types of health problems. To many patients, the clinics are
not only a place to receive medical care but also are a time to have
a social visit with friends.

Clinics are held on different days in the County Health De-
j partmenrs. In some of the smaller counties, they may be held
j only once a month. In the larger counties they may be held
j more than once a week. If you wish to visit a clinic and you do
not know when it is held, contact your County Health Depart-
ment and the staff members can tell you.

Nursing in the Larger Counties

Where Mrs. G may cover nearly all of her county, Miss B, who is
a public health nurse in a large county, is assigned a district where
she is responsible for the same nursing service as Mrs. G — clinics,
schools and home visits.

FLORIDA HEALTH NOTES • 215

i /../

The public health nurse gives a talk on health during a visit to a
school.

The nurse serves as liaison between the teacher and the child's
parents where health problems are slowing the child's progress.

Mrs. G's visits for the day may include an elderly diabetic woman
with an infected foot, who is receiving service under Medicare. She
will change the dressing while determining if the patient's food
habits should be altered, and/or discuss with the patient other
health problems.

• She also visits a 40-year-old father who has had a heart attack.
Following the physician's plan of treatment, Mrs. G may bathe the
patient, give an injection, and discuss with the wife a low sodium
diet.

When performing any nf the above nursing services, Mrs. G is
using her professional knowledge and drawing on the information

214

FLORIDA HEALTH NOTES

she receives from conferences, in service education, seminars and
other educational activities.

Clinical Services

As one of the two nurses in the county, Mrs. G works with the
county health director in the clinics. On the first and third Thurs-
day of the month, there are prenatal clinics. In some counties there
are maternal and infant care high-risk clinics where women who
may have complications during pregnancy and delivery of their
babies are given special attention.

On the second and fourth Thu *sday of the month, there are well-
baby clinics where infants are examined for growth and develop-
ment, weighed and given immunizations. In the postpartum period,
mothers are examined, their blood pressures and temperatures are
taken, and any problems they may have with the infants are dis-
cussed with the county health director and the public health nurse.
Family planning may also be discussed.

Genera] clinics are held once a week and Mrs. G and the director
see all types of health problems. To many patients, the clinics are
not only a place to receive medical care but also are a time to have
a social visit with friends.

| Clinics are held on different doys in the County Health De-
| partments. In some of the smaller counties, they may be held
j only once a month. In the larger counties they may be held
j more than once a week. If you wish to visit a clinic and you do '
j not know when it is held, contact your County Health Depart-
ment and the staff members can tell you.

*

Nursing in the Larger Counties

Where Mrs. G may cover nearly all of her county, Miss B, who is
a public health nurse in a large county, is assigned a district where
she is responsible for the same nursing service as Mrs. G — clinics,
schools and home visits.

FLORIDA HEALTH NOTES • 215

In some larger counties there is a wide variety of specialization
with one nurse in charge of all tuberculosis patients, another in
charge of clinics, a third acting as supervisor of home health aides,
and a fourth as coordinator at the hospital who arranges nursing
care for patients after they leave the hospital.

Few County Health Departments have nurses doing specialized
duty ; most of the 900 public health nurses in Florida do generalized
public health nursing as does Mrs. G.

Once Mrs. G and Miss B saw only those families who had a health
problem ; today they render service to nearly everyone in the com-
munity. Not only do they see the child whose family could not af-
ford private medical care, but now they test and refer schoolchildren
of the middle r.nd upper income brackets, some of whom may need
dental care or eye care because their parents are not aware of it.

For example, Miss B was asked to visit the home of a teenager
who was having crying spells in school. This student came from a
well-to-do family, which was giving the girl many so-called oppor-
tunities — music and drawing lessons, assisting her mother with
social functions — and yet expecting her to excel in her school work.
Miss B was able to help the parents see the need to limit these
activities for the emotional and physical stability of their child.

Continuing Education

The Division of Public Health Nursing has always encouraged
nurses to improve themselves through graduate programs and in-
service education programs which are provided throughout the
state. County wide inservice programs are conducted in the larger
counties while some of the smaller counties band together into
groups of six to eight counties.

Each county or group has a chairman, vice chairman and secre-
tary. Each group plans its program according to the needs of the
nurses, such as new programs. Topics may be child growth and
development, new nursing procedures or related fields. Resource

216

FLORIDA HEALTH NOTES

persons are available to talk to the groups on a variety of subjects,
such as diabetes, tuberculosis, home health aides or safety. During
these meetings the public health nurses have time for informal
exchanges of ideas and plans.

A nursing consultant from the Division of Public Health Nursing
is available to each County Health Department. The services of
the consultant depend upon the size of the county. In the smaller
counties, the public health nurse saves her questions and problems
for the consultant's visit. After listening to and discussing the
problems, the consultant may make home, school or nursing home
visits with the nurse. She, the consultant, may be asked to explain
a new program with a community group. She helps the public
health nurse to sharpen her professional practice. On most visits
the public health nurse and the consultant confer with the county
health director to discuss the suggestions the consultant has given
as well as to plan expanded and/or improved nursing services.

Nurse in Different Roles

A public health nurse is typically a warm individual with empathy
and sympathy. She is a person ready to help patients and their
families with health needs, enabling them to grow to their maxi-

A public health
nurse may spe-
cialize in training
and supervising
home health
aides.

polk cou-
nt

DEPa

In some larger counties there is a wide variety of socialization
with one nurse in charge of all tuberculosis patients, another in
charge of clinics, :t third acting as supervisor of home health aides,
and a fourth as coordinator at the hospital who arranges nursing
care for patients after they leave the hospital.

Few County Health Departments have nurses doing specialized
duty ; most of the 900 public health nurses in Florida do generalized
public health nursing as does Mrs. G.

Once Mrs. G and Miss B saw only those families who had a herdth
problem; today they render service to nearly everyone in the com-
munity. Not only do they see the child whose family could not af-
ford private medical care, but now they test and refer schoolchildren
of the middle end upper income brackets, some of whom may need
dental care or eye care because their parents are not aware of it.

For example. Miss B was asked to visit the home of a teenager
who was having crying spells in school. This student came from a
well-to-do family, which was giving the girl many so-called oppor-
tunities — music and drawing lessons, assisting her mother with
social functions — and yet exjiecting her to excel in her school work.
Miss B was able to help the parents see the need to limit these
activities for the emotional and physical stability of their child.

Continuing Education

The Division of Public Health Nursing has always encouraged
nurses to improve themselves through graduate programs and in-
service education programs which are provided throughout the
state. Countywide inservice programs are conducted in the larger
counties while some of the smaller counties band together into
groups of six to eight counties.

Each county or group has a chairman, vice chairman and secre-
tary. Each group plans its program according to the needs of the
nurses, such as new programs. Topics may be child growth and
development, new nursing procedures or related fields. Resource

216

FLORIDA HEALTH NOTES

persons are available to talk to the groups on a variety of subjects,
such as diabetes, tuberculosis, home health aides or safety. During
these meetings the public health nurses have time for informal
exchanges of ideas and plans.

A nursing consultant from the Division of Public Health Nursing
is available to each County Health Department. The services of
the consultant depend upon the size of the county. In the smaller
counties, the public health nurse saves her questions and problems
for the consultant's visit. After listening to and discussing the
problems, the consultant may make home, school or nursing home
visits with the nurse. She, the consultant, may lie asked to explain
8 new program with a community group. She helps the public
health nurse to sharpen her professional practice. On most visits
the public health nurse and the consultant confer with the county
health director to discuss the suggestions the consultant has given
as well as to plan expanded and/ or improved nursing services.

Nurse in Different Roles

A public health nurse is typically a warm individual with empathy
and sympathy. She is a person ready to help patients and their
families with health needs, enabling them to grow to their maxi-

POLK COUNTY

HEALTH

DEPARTMENT

1^1

A public health
nurse may spe-
cialize in Training
and supervising
home health
aides.

«{jf <fc>

I -

mum potential in life but not allowing them to become dependent
upon her.

To enable patients to relate to her, the public health nurse must
have a genuine warmth for people. In counseling with a patient, she
must not judge the person, but allow the patient to trust and feel
comfortable with her.

The public health nurse is a coordinator of many things — home,
hospital, nursing care, home-school relations, community and health
needs, etc. Since she is in direct contact with the people of the com-
munity, she is looked upon by official and voluntary health agencies
as the person who can help carry out their programs. The county
health director, social worker, mental health worker, psychologist,
physician, dentist, nutritionist, and sometimes the sanitarian, de-
pend upon her, but she is nevertheless a member of the County
Health Department team.

I

!

We hove covered only a part of the work of the public health
nurse. If you wish more information, write the Division of Public
Health Nursing, Florida State Board of Health, P. O. Box 210,
Jacksonville, Florida 32201.

f

J

THE SANITARIAN

The 340 sanitarians in Florida are charged with the administra-
tion of the health rules and regulations known as the Sanitary Code
of Florida. Only nine of the 67 counties have 10 or more sanitarians
while 46 County Health Departments have fewer than five to check
out nuisance and dog bite complaints, see that local restaurants are
clean places to eat, make sure that schools are safe places for
children, and see that home and commercial establishments have
proper water supplies and satisfactory systems for disposal of
liquid and solid wastes. Nuisance complaints indicate what the
general public feels are major health problems.

218

FLORIDA HEALTH NOTES

Clinical work is a
part of the public
health nurse's
work in small and
targe counties,
although some
counties have
specialists in this
field.

Because of operational policies in the different counties, there are
all shades of generalization and specialization in the sanitarians'
work. In a few of the larger counties there is a high degree of
specialization with each man responsible for a particular phase of
the work, such as trailer parks, food establishments or nursing
homes. In several counties, sanitarians are increasing their offer-
ings of training courses to food service personnel.

In one county there is partial specialization with the county
divided into districts and each man responsible for all environmen-
tal health work, except for swimming pools, air pollution, migrant
labor and food processing plants which are handled by sj>ecialists.

The majority of sanitarians, however, work on a generalized basis
within a specific district of the county. The environmental health

FLORIDA HEALTH NOTES

219

mum potential in life but not allowing- them to become dependent
upon her.

To enable patients to relate to her, the public health nurse must
have a genuine warmth for people. In counseling with a patient, she
must not judge the person, but allow the patient to trust and feel
comfortable with her.

The public health nurse is a coordinator of many things — home,
hospital, nursing care, home-school relations, community and health
needs, etc. Since she is in direct contact with the people of the com-
munity, she is looked upon by official and voluntary health agencies
as the person who can help carry out their programs. The county
health director, social worker, mental health worker, psychologist,
physician, dentist, nutritionist, and sometimes the sanitarian, de-
pend upon hei-, but she is nevertheless a member of the County
Health Department team.

We have covered only a part of the work of the public health
nurse. If you wish more information, write the Division of Public
Health Nursing, Florida State Board of Health, P. O, Box 210,
Jacksonville, Florida 32201.

4

THE SANITARIAN

The 340 sanitarians in Florida are charged with the administra-
tion of the health rules and regulations known as the Sanitary Code
of Florida, Only nine of the 67 counties have 10 or more sanitarians
while 46 County Health Departments have fewer than five to check
out nuisance and dog bite complaints, see that local restaurants are
clean places to eat, make sure that schools are safe places for
children, and see that home and commercial establishments have
proper water supplies and satisfactory systems for disposal of
liquid and solid wastes. Nuisance complaints indicate what the
general public feels are major health problems.

218 • FLORIDA HEALTH NOTES

Clinical work is a
port of the public
health nurse's
work in small and
large counties,
although some
counties have
specialists in this
field.

Because of operational policies in the different counties, there are
all shades of generalization and socialization in the sanitarians'
work. In a few of the larger counties there 13 a high degree of
specialization with each man responsible for a particular phase of
the work, such as trailer parks, food establishments or nursing
homes. In several counties, sanitarians are increasing their offer-
ings of training courses to food service personnel.

In one county there is partial specialization with the county
divided into districts and each man responsible for all environmen-
tal health work, except for swimming pools, air pollution, migrant
labor and food processing plants which are handled by specialists.

The majority of sanitarians, however, work on a generalized basis
within a specific district of the county. The environmental health

FLORIDA HEALTH NOTES

219

work setup depends greatly on the geographic make-up of the
county and the distribution of the population.

The Small County

Tom M, who is the only sanitarian in his county, carries on an
independent program under the direction of his county health di-
rector. He is responsible for setting up programs for environmental
health ; he conducts field investigations and surveys and sees that
sanitary practices are carried out in his county. Frequently he is
called upon by various local governmental agencies for his expert
advice on sanitary programs, such as planning of subdivisions or
the construction of buildings. Plans for sanitary sewers and sewage
treatment plants are approved by the regional sanitary engineer,
but Mr. M sees that they are built according to specifications. Like
a few other sanitarians, Mr. M is also responsible for the work of
the local Mosquito Control District.

A public health nurse, who specializes as a hospital coordinator in
one county, discusses future home nursing care with a hospitalized
patient, nurse and doctor.

220

FLORIDA HEALTH NOTES

Complaints take a great deal of Mr. M's time. During an average
day he:

• answers a complaint about a dog bite. Sometimes he has to see
that the dog is identified and the owner has the animal confined
until it is found not rabid;

• checks out a complaint about an overflowing septic tank. He
also obtains samples of private water supplies in the area and sends
them to the State Board of Health's laboratory ;

• inspects the lunchroom operation in a local school ;

• drives halfway across the county to check on the installation of
a septic tank ;

• inspects a trailer park and restaurant while he is in the vi-
cinity, and

• meets with a builder to discuss water and sewage requirements
for a new subdivision.

The Large County

John S, who is assigned a district in a large county, is responsible
for all phases of the environmental health work, except hospitals
and nursing homes, swimming pools, water works, sewage treat-
ment plants and child care centers. One county has over 200 such
child care centers which are inspected and licensed under a local
law. Fifteen of Florida counties have similar legislation at present.

Mr. S does have all food establishments in his district, schools,
trailer parks, rabies control and the answering of complaints. He
works closely with those men who are specialists and reports any
violation to them or the county sanitary engineer. Sanitarians also
consult with governmental agencies, such as county planning de-

FLORIDA HEALTH NOTES • 221

work setup depends greatly on the geographic make-up of the
county and the distribution of the population.

The Small County

Tom M, who is the only sanitarian in his county, carries on an
independent program under the direction of his county health di-
rector. He is responsible for setting up programs for environmental
health; he conducts field investigations and surveys and sees that
sanitary practices are carried out in his county. Frequently he is
called upon by various local governmental agencies for his expert
advice on sanitary programs, such as planning of subdivisions or
the construction of buildings. Plans for sanitary sewers and sewage
treatment plants are approved by the regional sanitary engineer,
but Mr. M sees that they are built according to specifications. Like
a few other sanitarians, Mr. M is also responsible for the work of
the local Mosquito Control District.

A public health nurse, who specializes as a hospital coordinator in
one county, discusses future home nursing care with a hospitalized
patient, nurse and doctor.

220

FLORIDA HEALTH NOTES

Complaints take a great deal of Mr. M's time. During an average
day he:

• answers a complaint about a dog bite. Sometimes he has to see
that the dog is identified and the owner has the animal confined
until it is found not rabid;

• checks out a complaint alxmt an overflowing septic tank. He
also obtains samples of private water supplies in the area and sends
them to the State Board of Health's laboratory;

• inspects the lunchroom operation in a local school;

• drives halfway across the county to check on the installation of
a septic tank ;

• inspects a trailer park and restaurant while he is in the vi-
cinity, and

• meets with a builder to discuss water and sewage requirements
for a new subdivision.

The Large County

John S, who is assigned a district in a large county, is responsible
for all phases of the environmental health work, except hospitals
and nursing homes, swimming pools, water works, sewage treat-
ment plants and child care centers. One county has over 200 such
child care centers which are inspected and licensed under a local
law. Fifteen of Florida counties have similar legislation at present.

Mr. S does have all food establishments in his district, schools,
trailer parks, rabies control and the answering of complaints. He
works closely with those men who are specia lists and reports* any
violation to them or the county sanitary engineer. Sanitarians also
consult with governmental agencies, such as county planning de-

FLORIDA HEALTH NOTES • 221

partments and city public works departments, regarding local en-
vironmental health problems and needs.

Planning is necessary to carry out an effective program. The
director of environmental health has an overall picture of the pro-
gram and tries to direct and coordinate the efforts of his staff. Mr.
S knows he has a set number of establishments to inspect —
restaurants, schools and trailer parks. These he can plan to cover
within a specified time. What he cannot plan is the number of
complaints and dog bites that must be investigated. Reports must
be made and filed.

The workload of the sanitarian is the sum total of establish-
ments, facilities and situations for which he is responsible, plus
sampling, testing, conferences, training and record keeping. In
one county survey, sanitarians were found to spend an average of

The sanitar-
ian needs to
check plans for
such projects as
sewerage systems
to make sure they
are built to speci-
fications.

222

FLORIDA HEALTH NOTES

22.2 per cent of their time in traveling from the office to work in
the field or from one place to another. An additional 16 per cent of
their time was spent in the office doing necessary paper work and
answering telephone calls and meeting with people.

Problems for the Sanitarian

The expanding population has increased the workload of Tom M
and John S. They face many special problems which are compli-
cated by the lack of money or adequate local zoning ordinances.
Some of these problems are :

• garbage and trash disposal. Many unincorporated areas have
poor or no garbage disposal plan or no laws to require householders
to utilize available private collection service;

• exotic solid wastes. Automobile bodies, wornout home appli-
ances, bed springs and mattresses and lawn debris always present
a special problem in mosquito and rodent control;

• food service. Sometimes inspection of eating establishments at
peak hours is important to check on work habits, food storage and
potential food hazards which do not show up at other times. Sani-
tarians are also responsible for the sanitary conditions and safety
of foods in food outlets (grocery and meat stores). They also in-
vestigate food poisoning outbreaks, obtain food samples, interpret
laboratory results, and advise on the application of the findings
toward the elimination of future food-borne outbreaks;

• enforcement. Sanitarians stress environmental health educa-
tion in getting people to understand the importance of the Sanitary
Code. Where health laws are violated, the sanitarians make re-
peated attempts through education to get the violations corrected.
Offenders are usually provided opportunity for hearings before
being taken to court. This last step is seldom needed.

FLORIDA HEALTH NOTES • 223

partments and city public works departments, regarding local en-
vironmental health problems and needs.

Planning is necessary to carry out an effective program. The
director of environmental health has an overall picture of the pro-
gram and tries to direct and coordinate the efforts of his staff. Mr.
S knows he has a set number of establishments to inspect —
restaurants, schools and trailer parks. These he can plan to cover
uithin a specified time. What he cannot plan is the number of
complaints and dog bites that must be investigated. Reports must
be made and filed.

The workload of the sanitarian is the sum total of establish-
ments, facilities and situations for which he is responsible, plus
sampling, testing, conferences, training and record keeping. In
one county survey, sanitarians were found to spend an average of

The sanitar-
ian needs to
check plans for
such projects as
sewerage systems
to make sure they
are built to speci-
fications.

222

FLORIDA HEALTH NOTES

22.2 per cent of their time in traveling from the office to work in
the field or from one place to another. An additional 16 per cent of
their time was spent in the office doing necessary paper work and
answering telephone calls and meeting with people.

Problems for the Sanitarian

The expanding population has increased the workload of Tom M
and John S. They face many special problems which are compli-
cated by the lack of money or adequate local zoning ordinances.
Some of these problems are :

• garbage and trash disposal. Many unincorporated areas have
poor or no garbage disposal plan or no laws to require householders
to utilize available private collection service;

• exotic solid wastes. Automobile bodies, wornout home appli-
ances, bed springs and mattresses and lawn debris always present
a special problem in mosquito and rodent control ;

• food service. Sometimes inspection of eating establishments at
peak hours is important to check on work habits, food storage and
potential food hazards which do not show up at other times. Sani-
tarians are also responsible for the sanitary conditions and safety
of foods in food outlets (grocery and meat stores). They also in-
vestigate food poisoning outbreaks, obtain food samples, interpret
laboratory results, and advise on the application of the findings
toward the elimination of future food-borne outbreaks ;

• enforcement. Sanitarians stress environmental health educa-
tion in getting people to understand the importance of the Sanitary
Code. Where health laws are violated, the sanitarians make re-
peated attempts through education to get the violations corrected.
Offenders are usually provided opportunity for hearings before
being taken to court. This last step is seldom needed.

FLORIDA HEALTH NOTES • 223

Taking water
samples is routine
work for the sani-
tarian. Before
drawing the water
he uses a blow
torch to kill the
bacteria on the
faucet.

• dog bites. Finding the offending dog and instructing its owner
to have the animal confined are frequent problems. Sometimes
police and sheriffs deputies assist by answering dog bite calls when
the County Health Department is not open. If the dog has had
rabies vaccine within the previous 12 months, the animal may be
confined at home. If not, the dog must be taken to a pound or
animal hospital at the owner's expense. The sanitarian releases the
dog at the end of 10 days if there is no sign of rabies.

Education, Recruiting and Training

The beginning sanitarian is required to have a Bachelor of Arts
or Science degree but his education does not stop here. Besides be-
ing responsible for recruiting of sanitarians for the County Health
Departments, the State Board of Health's Division of Sanitation is
responsible for training programs and it encourages the sanitarians
to take graduate work or correspondence courses.

The Division gives a 12-week training course twice a year for
new sanitarians. This course covers the basic environmental health
field. Topical courses for more advanced studies are also offered in

224

FLORIDA HEALTH NOTES

such subjects as program administration, swimming pools, common
carriers, food hygiene, waste disposal, environmental health and
sanitary practices.

A total of 150 sanitarians has taken one or more of the four
correspondence courses offered by the Communicable Disease Cen-
ter of the U. S. Public Health Service and coordinated by the
Division of Sanitation. These courses are in basic mathematics;
insect, rodent and vector control; communicable disease control;
and environmental sanitation. Sixty-two sanitarians are currently
enrolled in their second course.

Inspection of res-
taurant equip-
roent is an im-
portant part of
the sanitarian's
duties.

Taking water
samples is routine
work for the sani-
tarian. Before
drawing the water
he uses a blow
torch to kill the
bacteria on t h e
faucet.

• dog bites. Finding the offending dog and instructing its owner
to have the animal confined are frequent problems. Sometimes
police and sheriff's deputies assist by answering dog bite calls when
the County Health Department is not open. If the dog has had
rabies vaccine within the previous 12 months, the animal may be
confined at home. If not, the dog must be taken to a pound or
animal hospital at the owner's expense. The sanitarian releases the
dog at the end of 10 days if there is no sign of rabies.

Education, Recruiting and Training

The beginning sanitarian is required to have a Bachelor of Arts
or Science degree but his education does not stop here. Besides be-
ing responsible for recruiting of sanitarians for the County Health
Departments, the State Board of Health's Division of Sanitation is
responsible for training programs and it encourages the sanitarians
to take graduate work or correspondence courses.

The Division gives a 12-week training course twice a year for
new sanitarians. This course covers the basic environmental health
field. Topical courses for more advanced studies are also offered in

224

FLORIDA HEALTH NOTES

such subjects as program administration, swimming pools, common
carriers, food hygiene, waste disposal, environmental health and
sanitary practices.

A total of 150 sanitarians has taken one or more of the four
correspondence courses offered by the Communicable Disease Cen-
ter of the U. S. Public Health Service and coordinated by the
Division of Sanitation. These courses are in basic mathematics;
insect, rodent and vector control; communicable disease control;
and environmental sanitation. Sixty-two sanitarians are currently
enrolled in their second course.

*iCS

4MtfK

Inspection of res-
taurant equip-
ment is on im-
portant- part of
the sanitarian's
duties.

The Division of Sanitation also has consultants who work closely
with the County Health Departments. In the larger counties, they
help with the planning and evaluation of programs. In the smaller
counties, the sanitarians, such as Tom M, frequently save up their
questions for the consultant's visit. The two work out solutions to
the problems and the results are applied and evaluated. Environ-
mental health programs are also planned during these visits.

The sanitarian consultants, as well as staff members of all bu-
reaus and divisions of the State Board of Health, are always avail-
able to the County Health Departments for help in any special
problems, such as food poisoning outbreak.

I

We have had room only to touch the highlights of the sani
j tartan's work. If you want more information, write the Division
J of Sanitation, Florida State Board of Health, P. O. Box 210, (
■ Jacksonville, Florida 32201. I

YOU AND YOUR COUNTY HEALTH DEPARTMENT

Yes, it is your County Health Department. You may not have
need to use its facilities, but you should know something about its
operation and staff members. The cost of running the 67 County
Health Departments in 1966 came to nearly $12 million. This
money came from your taxes paid to city, state and federal govern-
ments, your Board of County Commissioners and your Board of
Public Instruction, plus fees and miscellaneous incomes. Of course
this is not all of the money spent for public health in Florida in
1966. The State Board of Health also had a multi-million dollar
budget.

Perhaps you already know how your County Health Department
operates or you may know some of the staff members. If you have
a question about health or wish to find out more about your County
Health Department, make a point to become acquainted with the
people who bring public health to your community. They will wel-
come your interest, support and confidence.

Photograph on page 212 courtesy of Lakeland Ledger. Lakeland, Florida.

226 • FLORIDA HEALTH NOTES

■

FUORtPA STATE MSRAPY

The Division of Sanitation also has consultants who work closely
with the County Health Departments. In the larger counties, they
help with the planning and evaluation of programs. In the smaller
counties, the sanitarians, such as Tom M, frequently save up their
questions for the consultant's visit. The two work out solutions to
the problems and the results are applied and evaluated. Environ-
mental health programs ace cilso planned during these visits.

The sanitarian consultants, as well as staff members of all bu-
reaus and divisions of the State Board of Health, are always avail-
able to the County Health Departments for help in any special
problems, such as food poisoning outbreak.

j We have had room only to touch the highlights of the sani-

| tartan's work. If you want more information, write the Division I

j of Sanitation, Florida State Board of Health, P. O. Box 210, I

■ Jacksonville, Florida 32201. I

I

YOU AND YOUR COUNTY HEALTH DEPARTMENT

Yes, it is your County Health Department. You may not have
need to use its facilities, but you should know something about its
operation and staff members. The cost of running the C7 County
Health Departments in 19CG came to nearly $12 million. This
money came from your taxes paid to city, state and federal govern-
ments, your Board of County Commissioners and your Board of
Public Instruction, plus fees and miscellaneous incomes. Of course
this is not all of the money spent for public health in Florida in
19G(j. The State Board of Health also had a multi-million dollar
budget.

Perhaps you already know how your County Health Department
operates or you may know some of the staff members. If you have
a question about health or wish to find out more about your County
Health Department, make a point to become acquainted with the
people who bring public health to your community. They will wel-
come youj- interest, support and confidence.

Photograph tm pane 212 courtesy of Lakeland Lrdytr, Liikt'Iand, Florida.

226 • FLORIDA HEALTH NOTES

FLORIDA

HEALTH
NOTES

'O 1ME 59 — NO. 5

»..

1967

Han, Mosquitoes and Microbes

FLOF : r?A. STATE UBRAKV

(Cover photo) A salt marsh mos-
quito, AEDES SOLLICITANS, takes a
meal of blood from a human finger.
If the mosquito has a virus, it would
pass it on to the human through a
salivary fluid which the mosquito in-
jects into the human during the
meal.

Arthropod -borne diseases are norm-
ally carried by mosquitoes from one
bird to another or to a rodent. These
serve as reservoirs for the diseases.
When horses or men are bitten by a
virus- carrying mosquito, they be-
come ill and sometimes die.

Man, Mosquitoes and Microbes

It's summertime in Florida !

At one time summer meant "mosquito-time" and life was con-
sidered unbearable; pestilences raged; a member of Congress said
that the state could never be developed, was not a fit place to live,
and described it as a land of swamps, alligators, frogs and mos-
quitoes. Today, only a few decades later, mosquito control has made
Florida a year-around tourist's paradise, a retirement place and a
desirable spot for enjoyable living.

Ever since the Spaniards, and recorded history, touched these
shores, man and the mosquito have been bitter enemies. This in-
sect has been known as a biting pest for centuries, but only since
the beginning of the 20th Century has man known that yellow
fever, malaria, dengue fever and some viral encephalitides were
arthropod-borne diseases.

Mosquitoes have always been considered one of the unpleasant
things in life. The knowledge of how to eradicate these pests and
the diseases they carry is being acquired through research carried
on by the State Board of Health, the U. S. Public Health Service,
the U. S. Department of Agriculture, mosquito control districts,
private philanthropic foundations and other governmental agencies.

This issue of Florida Health Notes will tell you about

• the dangers engendered by the mosquito ;

• the fight to make the state pleasantly livable for you, for the
six million other residents of the state and for 17 million annual
visitors; and

• the research being conducted to find the intimate secrets of a
mosquito's life and to control arthropod-borne diseases.

FLORIDA HEALTH NOTES • 231

Man - The Victim

From the earliest days mosquitoes have been a nuisance in Flor-
ida. They have played a prominent part in the slow development
of this subtropical gem called Florida, even though the state other-
wise had much to offer its residents and visitors. The beauty of
the Sunshine State has been marred by 67 species of mosquitoes,
several of them carrying- disease and/or otherwise making life in-
tolerable.

The mosquito was such a plague when the Spaniards arrived that
they named what today is Ponce de Leon Inlet, or Mosquito Inlet,
"Barro de Mosquitos." Since the time of the earliest maps, one of
which dates from 1615, some of Florida's inlets, lagoons and sec-
tions have borne the name Mosquito. In the 18th Century, the part
of Florida lying between the St. Johns River and the coastal lagoons
north of Cape Canaveral was called "The Mosquito Country," or
"The Mosquitoes."

Two lagoons in the area were named North and South Mosquito
Lagoons. When the British owned Florida, they tried to improve
the nomenclature by naming the north lagoon after the Earl of
Halifax and the south lagoon after the Earl of Hillsboro. Later in
the 19th Century, these names became official but the Hillsboro
River was changed about 40 years ago to North Indian Lagoon to
avoid confusion with a stream near Tampa,

FLORIDA HEALTH NOTES

Published monthly by the Florido Stote Board of Health, Wilson T. Sawder, M.D,, M.P.H.,
Store Health Officer. Publication office. Box 210. Jacksonville, Florida 32201, Second class
postage oatd at Jacksonville, Florida. This publication is for individuals and institutions with
an interest in the state's health programs. Permission is given to quote any story providing
credit is Given to the Florido Stote Board of Health. Editor: Robert A, Schoonover, M.A ,
Division of Health Education.

VOLUME 59— HO. I MAY 1967

232 • FLORIDA HEALTH NOTES

>"' " ', '-Vol I

J0 f

r*£

Hundreds of thousands of mosquito pupae clog a ditch. Unless they are
destroyed, adult mosquitoes will emerge within a few hours and take flight
at twilight.

In 1824 when Mosquito Country was made into a county which
included a large portion of peninsular Florida, governmental offi-
cials could think of no more appropriate name than "Mosquito
County." The Florida Legislature changed the disagreeable name
to Orange County in 1846.

The insect was feared by armies that fought across Florida.
Soldiers were so beset by mosquitoes during skirmishes that the
men were unable to fight.

For many years settlements were restricted to the northern sec-
tion of the state. The southern portion was a series of swamps,
lakes, rivers and hammocks populated mostly by hoards of mos-
quitoes and other biting insects. Even though northern Florida was
settled, it suffered from disease, hardship and poverty. With the
exception of Key West, the major cities — Tallahassee, Jacksonville,

FLORIDA HEALTH NOTES

233

Man - The Victim

From the earliest days mosquitoes have been a nuisance in Flor-
ida. They have played a prominent part in the slow development
of this subtropical gem called Florida, even though the state other-
wise had much to offer its residents and visitors. The beauty of
the Sunshine State has been marred by 67 species of mosquitoes,
several of them carrying disease and/or otherwise making life in-
tolerable.

The mosquito was such a plague when the Spaniards arrived that
they named what today is Ponce de Leon Inlet, or Mosquito Inlet,
"Barro de Mosquitos." Since the time of the earliest maps, one of
which dates from 1615, some of Florida's inlets, lagoons and sec-
tions have borne the name Mosquito. In the 18th Century, the part
of Florida lying between the St. Johns River and the coastal lagoons
north of Cape Canaveral was called "The Mosquito Country," or
"The Mosquitoes."

Two lagoons in the area were named North and South Mosquito
Lagoons. When the British owned Florida, they tried to improve
the nomenclature by naming the north lagoon after the Earl of
Halifax and the south lagoon after the Earl of Hillsboro. Later in
the 19th Century, these names became official but the Hillsboro
River was changed about 40 years ago to North Indian Lagoon to
avoid confusion with a stream near Tampa.

FLORIDA HEALTH NOTES

Published monthly by the Florida State Board of Health. Wilson T Sawder. M D M P.H..
State Hoatih Officer Publication office. Box 210, Jacksonville Florida 32201. Second don
postage paid or Jacksonville, Florida. This publxat on is for individuals ond institutions with
on interest in the state's health programs Permission is given to quote any story providing
credit is g>ven to the Florida State Board of Health Ed. tor Robert A. Schoonover, M,A.,
Division of Health {Education.

VOLUME 59— NO. 5 MAY 1M7

232 • FLORIDA HEALTH NOTES

/tlB

Hundreds of thousands of mosquito pupae clog a ditch. Unless they are
destroyed, adult mosquitoes will emerge within a few hours and take flight
at twilight.

In 1824 when Mosquito Country was made into a county which
included a large portion of peninsular Florida, governmental offi-
cials could think of no more appropriate name than "Mosquito
County." The Florida Legislature changed the disagreeable name
to Orange County in 1845.

The insect was feared by armies that fought across Florida.
Soldiers were so beset by mosquitoes during skirmishes that the
men were unable to fight.

For many years settlements were restricted to the northern sec-
tion of the state. The southern portion was a series of swamps,
lakes, rivers and hammocks populated mostly by hoards of mos-
quitoes and other biting insects. Even though northern Florida was
settled, it suffered from disease, hardship and poverty. With the
exception of Key West, the major cities — Tallahassee, Jacksonville,

FLORIDA HEALTH NOTES

233

St. Augustine and Pensacola — were in this area, which was known
as the "malaria belt."

Every year deadly fevers spread consternation throughout the
region. Shops were closed; fear of the epidemic and the stifling
heat caused those who could afford the expense to migrate North
to more healthful climates for the months of August, September,
October and November. Those who w T ere forced to stay behind
suffered through the pestilent seasons or were buried in the large
cemeteries which marred the beauty of the region.

When the statehood of Florida was being debated in Congress,
John Randolph of Virginia stated that Florida could never be de-
veloped, nor would it ever be a fit place to live. He described the
region as "a land of swamps, of quagmires, of frogs and alligators
and mosquitoes."

The Story of Yellow Fever

For years yellow fever brought fear and panic to many Florida
cities which were visited by ships from the Caribbean and Central
and South America. Commerce and passengers arriving in Florida
ports seemed to be accompanied by wave after wave of yellow fever.
Many strange remedies were recommended. Mail and cargo were

•^r

An air plant, or brome-
liad, is the breeding
place of several
species of mosquitoes,
including AEDES
AEGYPTJ, the yellow
fever carrying mos-
quito.

234 •

fumigated ; cannons were fired ; lime was spread in the streets,
houses and shops ; bonfires were lit at night.

The 1877 yellow fever epidemic in Fernandina and Jacksonville
was described by historians as the state's greatest holocaust.
Fernandina, with a population of 1632, had 1146 persons ill with the
fever. Twenty -four died. In 1887, yellow fever epidemics raged in
Key West, Tampa, Plant City and Manatee. The panic was so wide-
spread in Tampa that lighted lamps were left and stoves were still
burning when people fled the city in haste. The 1888 epidemic in
Jacksonville saw some 10,000 persons (out of a population of
26,800 in Duval County) flee the city in carriages, drays, wagons,
trains and ships laden to capacity.

The yellow fever epidemics brought about the creation of the
State Board of Health. Although nobody knew it at the time, the
public health programs of Florida had their beginning in the mos-
quito. By 1901 this insect was discovered to be the transmitter of
yellow fever. Following an epidemic in Pensacola in 1905, the
quarantining of ships which were thought to be bringing the vector
from foreign ports, the screening and spraying of homes, the
destruction of adult mosquitoes and the prevention of mosquito
breeding brought about an end to the fearsome epidemics.

The mosquito was also incriminated in the transmission of dengue
fever and malaria. Although obervations were made by the first
State Health Officer, Dr. Joseph Y. Porter, that attacks of malaria
were more deadly along the river bottoms, marshlands and in the
flatwoods, no concerted efforts were made to control malaria until
World War I when drainage and larviciding were carried out at
Camp Johnson by the joint efforts of the U. S. Army, the U. S.
Public Health Service and the State Board of Health.

Mosquito Control's Beginning

The first malaria control program was undertaken by the State
Board of Health in Perry in 1920. At the time it was the largest
project of its kind in the country. A total of $28,000 was spent and
47,000 eubic yards of dirt moved to make drainage ditches and
canals. The cost of the project was borne by the City of Perry,

FLORIDA HEALTH NOTES • 235

St. Augustine and Pensacola — were in this area, which was known
as the "malaria belt."

Every year deadly fevers spread consternation throughout the
region. Shops were closed; fear of the epidemic and the stifling
heat caused those who could afford the expense to migrate North
to more healthful climates for the months of August, September,
October and November. Those who were forced to stay behind
suffered through the pestilent seasons or were buried in the large
cemeteries which marred the beauty of the region.

When the statehood of Florida was being debated in Congress,
John Randolph of Virginia stated that Florida could never be de-
veloped, nor would it ever be a fit place to live. He described the
region as "a land of swamps, of quagmires, of frogs and alligators
and mosquitoes."

The Story of Yellow Fever

For years yellow fever brought fear and panic to many Florida
cities which were visited by ships from the Caribbean and Central
and South America. Commerce and passengers arriving in Florida
ports seemed to be accompanied by wave after wave of yellow fever.
Many strange remedies were recommended. Mail and cargo were

An air plant, or brome-
liad, is Hie breeding
place of several
species of mosquitoes,
including AEDES
AEGYPT1, the yellow
fever carrying mos-
quito.

234 •

fumigated ; cannons were fired ; lime was spread in the streets,
houses and shops ; bonfires were lit at night.

The 1877 yellow fever epidemic in Fernandina and Jacksonville
was described by historians as the state's greatest holocaust.
Fernandina, with a population of 1632, had 1146 persons ill with the
fever. Twenty -four died. In 1887, yellow fever epidemics raged in
Key West, Tampa, Plant City and Manatee. The panic was so wide-
spread in Tampa that lighted lamps were left and stoves were still
burning when people fled the city in haste. The 1888 epidemic in
Jacksonville saw some 10,000 persons (out of a population of
26,800 in Duval County) flee the city in carriages, drays, wagons,
trains and ships laden to capacity.

The yellow fever epidemics brought about the creation of the
State Board of Health. Although nobody knew it at the time, the
public health programs of Florida had their beginning in the mos-
quito. By 1901 this insect was discovered to be the transmitter of
yellow fever. Following an epidemic in Pensacola in 1905, the
quarantining of ships which were thought to be bringing the vector
from foreign ports, the screening and spraying of homes, the
destruction of adult mosquitoes and the prevention of mosquito
breeding brought about an end to the fearsome epidemics.

The mosquito was also incriminated in the transmission of dengue
fever and malaria. Although obervations were made by the first
State Health Officer, Dr. Joseph Y. Porter, that attacks of malaria
were more deadly along the river bottoms, marshlands and in the
flat woods, no concerted efforts were made to control malaria until
World War I when drainage and larviciding were carried out at
Camp Johnson by the joint efforts of the U. S. Army, the U. S.
Public Health Service and the State Board of Health.

Mosquito Control's Beginning

The first malaria control program was undertaken by the State
Board of Health in Perry in 1920. At the time it was the largest
project of its kind in the country. A total of $28,000 was spent and
47,000 cubic yards of dirt moved to make drainage ditches and
canals. The cost of the project was borne by the City of Pen v.

FLORIDA HEALTH NOTES • 235

Taylor County and the Burton Swartz Cypress Company with the
State Board of Health supplying technical supervision. The result-
ing better health of the people of the area proved the benefits of
the project.

Further progress in controlling malaria, and subsequently mos-
quitoes, was made when the Rockefeller Foundation established a
malaria control research station at Tallahassee in 1931. This sta-
tion, working in conjunction with the State Hospital at Chatta-
hoochee and the State Board of Health, gave inestimable value to
work in the malaria field. A mosquito eontrol research station was
also established in Orlando in 1932 by the U. S. Department of
Agriculture and later moved to Gainesville.

The State Board of Health created the Bureau of Malaria Control
in 1941 to study and make recommendations for controlling malaria
in the state. This became the Bureau of Entomology in 1946 and
the scope of activity was made to cover all work pertaining to all
arthropods transmitting human diseases or annoying man by their
bites.

The State Board of Health's Entomological Research Center at
Vero Beach was established in 1955 to study Florida's biting in-
sects, particularly mosquitoes, sand flies and yellow flies. The aim
was to eliminate these nuisances from the Florida scene. The
Encephalitis Research Center was established at Tampa in 1962
following an epidemic of St. Louis encephalitis to investigate the
viruses carried by arthropods and, if possible, bring about some
kind of control. The work of these centers will be discussed later
in this issue of Health Notes.

Mosquito - The Villain

The mosquito is a long-time, undesirable resident of Florida.
Humans living in the state have been swatting mosquitoes for gen-
erations but eradication is most difficult. There are 67 species in
the state and each has its own particular mating and breeding
habits, living and resting areas, and its own preference for food —

236 • FLORIDA HEALTH NOTES

J

This motorized vacuum machine has been developed by staff members of
the State Board of Health to collect blood -engorged female mosquitoes
from their resting places among woodland debris.

which may be human blood. Seven of the 67 species have been im-
plicated in the carrying of arthropod-borne diseases which are
seriously affecting humans and animals.

The Female is Deadly

As everyone knows, the female mosquito is the one that causes
the problems because she is the one that bites and carries disease.
The male mosquito spends his short life on the edge of breeding
areas, mating with any female that comes near, sipping nectar from
flowers and performing his "twilight dances."

Life for mosquitoes begins as an egg laid on water or moist soil,
or inside a can, tire, air plant, tree hole or most anything that holds
water. The larvae, curled up inside the eggs, hatch at once if in
water or may stay that way for weeks or months until rain or
tidewater covers them. The free-swimming larvae, or wigglers,
grow through several changes of skin in about five to seven days
and change into pupae which look like animated commas. In a
couple of days, the pupa's skin splits up the back and out emerges
the winged and "lance-equipped" adult mosquito.

FLORIDA HEALTH NOTES

237

•

Taylor County and the Burton Swartz Cypress Company with the
State Board of Health supplying technical supervision. The result-
ing- better health of the people of the area proved the benefits of
the project.

Further progress in controlling malaria, and subsequently mos-
quitoes, was made when the Rockefeller Foundation established a
malaria control research station at Tallahassee in 1931. This sta-
tion, working in conjunction with the State Hospital at Chatta-
hoochee and the State Board of Health, gave inestimable value to
work in the malaria field. A mosquito control research station was
also established in Orlando in 1932 by the U. S. Department of
Agricultui-e and later moved to Gainesville.

The State Board of Health created the Bureau of Malaria Control
in 1941 to study and make recommendations for controlling malaria
in the state. This became the Bureau of Entomology in 1946 and
the scope of activity was made to cover all work pertaining to all
arthropods transmitting human diseases or annoying man by their
bites.

The State Board of Health's Entomological Research Center at
Vero Beach was established in 1955 to study Florida's biting in-
sects, particularly mosquitoes, sand flies and yellow flies. The aim
was to eliminate these nuisances from the Florida scene. The
Encephalitis Research Center was established at Tampa in 1962
following an epidemic of St. Louis encephalitis to investigate the
viruses carried by arthropods and, if possible, bring about some
kind of control. The work of these centers will be discussed later
in this issue of Health Notes.

Mosquito - The Villain

The mosquito is a long-time, undesirable resident of Florida.
Humans living in the state have been swatting mosquitoes for gen-
erations but eradication is most difficult. There are 67 species in
the state and each has its own particular mating and breeding
habits, living and resting areas, and its own preference for food —

236 • FLORIDA HEALTH NOTES

rigm

- V>

J II

F

This motorized vacuum machine has been developed by staff members of
the State Board of Health to collect blood -engorged female mosquitoes
from their resting places among woodland debris.

which may be human blood. Seven of the 67 species have been im-
plicated in the carrying of arthropod-borne diseases which are
seriously affecting humans and animals.

The Female is Deadly

As everyone knows, the female mosquito is the one that causes
the problems because she is the one that bites and carries disease.
The male mosquito spends his short life on the edge of breeding
areas, mating with any female that comes near, sipping nectar from
flowers and performing his "twilight dances."

Life for mosquitoes begins as an egg laid on water or moist soil,
or inside a can, tire, air plant, tree hole or most anything that holds
water. The larvae, curled up inside the eggs, hatch at once if in
water or may stay that way for weeks or months until rain or
tidewater covers them. The free-swimming larvae, or wigglers,
grow through several changes of skin in about five to seven days
and change into pupae which look like animated commas. In a
couple of days, the pupa's skin splits up the back and out emerges
the winged and "lance-equipped" adult mosquito.

FLORIDA HEALTH NOTES

237

Mosquitoes are iden-
tified and counted in
several laboratories of
the State Board of
Health.

The newly-emerged mosquito must wait six to eight hours before
it can fly away from the place of its birth. Then, if it is dark, it
may migrate from two to 10 miles. Entomologists, using radio-
active means of marking mosquitoes, have found some species
that will migrate up to 25 miles. The migrations appear to be
mechanical — an urge to go somewhere. Following the migration,
the female mosquito settles down to a life of obtaining food, waiting
for her eggs to mature and then laying them. She goes through
several cycles of this and then expires at the ripe old age of two or
three weeks. Frequently the female needs a blood meal for her eggs
to mature but this is not true of all species.

238

FLORIDA HEALTH NOTES

!

The elimination of the mosquito from the Florida scene is being
researched and carried out in all stages of its life — the egg, larvae,
pupae and adult. The first three stages can be accomplished by
natural enemies of the mosquito, such as fish, or with larvicides;
removal of breeding places, such as ditching and draining of
swamps; or removal of water-holding containers left by humans.

The eradication of the adult is necessary because of the biting
habits of the female or because of a sudden epidemic of encephalitis
that does not allow time for the reduction of mosquitoes in their
breeding places. Fogging and spraying therefore become necessary.

All techniques to control mosquitoes must be safe for man and be
harmless to valuable forms of life in the mosquito's environment.
For example, when controlling pasture-breeding mosquitoes, other
forms of wildlife must be considered at the same time that mos-
quito production is halted. When draining, filling or flooding
marshes, other life in the swamps must be considered. While useful
forms of life must be preserved, the application of insecticides,
such as the spraying of homes in malaria control, "may have a bene-
ficial side effect by destroying other domestic pests — flies, roaches
and ants.

Where Do Mosquitoes Breed?

As previously stated, each mosquito species prefers its own
breeding place. Some are domesticated and breed in and around
the dwelling places of humans or on lands converted to human use,
such as pastures, groves, ditches, drains or even in polluted waters.
Other mosquitoes prefer wild lands, such as swamps, ponds and
woodland pools — far away from man and his habitats. Some species
are not particular and will breed in both places.

The Domestic Mosquito

Aedes aegypti, the mosquito that carries yellow fever and dengue
fever, is the most domesticated. It breeds around man's home in
cans, old tires, bird baths, drains, vases, tree holes, air plants —
anywhere water can collect. The eggs are laid on the side of the
container, just above the water line. The adult seldom flies from its
breeding place. At the present time there is an intensive federally-

FLORIDA HEALTH NOTES • 239

Mosquitoes ore iden-
tified and counted in
several laboratories of
the State Board of
Health.

The newly-emerged mosquito must wait six to eight hours before
it can fly away from the place of its birth. Then, if it is dark, it
may migrate from two to 10 miles. Entomologists, using radio-
active means of marking mosquitoes, have found some species
that will migrate up to 25 miles. The migrations appear to be
mechanical — an urge to go somewhere. Following the migration,
the female mosquito settles down to a life of obtaining food, waiting
for her eggs to mature and then laying them. She goes through
several cycles of this and then expires at the ripe old age of two or
three weeks. Frequently the female needs a blood meal for her eggs
to mature but this is not true of all species.

238

FLORIDA HEALTH NOTES

The elimination of the mosquito from the Florida scene is being
researched and carried out in all stages of its life — the egg, larvae,
pupae and adult. The first three stages can be accomplished by
natural enemies of the mosquito, such as fish, or with larvicides;
removal of breeding places, such as ditching and draining of
swamps; or removal of water-holding containers left by humans.

The eradication of the adult is necessary because of the biting
habits of the female or because of a sudden epidemic of encephalitis
that does not allow time for the reduction of mosquitoes in their
breeding places. Fogging and spraying therefore become necessary.

All techniques to control mosquitoes must be safe for man and be
harmless to valuable forms of life in the mosquito's environment.
For example, when controlling pasture-breeding mosquitoes, other
forms of wildlife must be considered at the same time that mos-
quito production is halted. When draining, filling or flooding
marshes, other life in the swamps must be considered. While useful
forms of life must be preserved, the application of insecticides,
such as the spraying of homes in malaria control, may have a bene-
ficial aide effect by destroying other domestic pests — flies, roaches
and ants.

Where Do Mosquitoes Breed?

As previously stated, each mosquito species prefers its own
breeding place. Some are domesticated and breed in and around
the dwelling places of humans or on lands converted to human use,
such as pastures, groves, ditches, drains or even in polluted waters.
Other mosquitoes prefer wild lands, such as swamps, ponds and
woodland pools — far away from man and his habitats. Some species
are not particular and will breed in both places.

The Domestic Mosquito

Aedes aegypti, the mosquito that carries yellow fever and dengue
fever, is the most domesticated. It breeds around man's home in
cans, old tires, bird baths, drains, vases, tree holes, air plants —
anywhere water can collect. The eggs are laid on the side of the
container, just above the water line. The adult seldom flies from its
breeding place. At the present time there is an intensive federally-

FLORIDA HEALTH NOTES • 239

supported program in Florida to eradicate A. aegypti. This cam-
paign is part of a nationwide program being carried out to fulfill
a commitment under international treaty with South and Central
American nations to eradicate the yellow fever carrying mos-
quito from the Americas.

Culex nigri palpus, the mosquito implicated as the carrier of St.
Louis encephalitis in Florida, is a wide breeder. It likes all kinds of
man-made places — agricultural fields, irrigated pastures and
groves, fallow fields, grassy and drainage ditches, floating exotic
plants, home premises and polluted waters.

Culex quinquefasciatus, which transmits bird malaria, fowl-pox
and other diseases, breeds in temporary receptacles, drainage
ditches and polluted water. It is also a carrier of St. Louis encepha-
litis throughout the United States, but it has not yet been in-
criminated in Florida.

The Salt Marsh Mosquito

Two of the greatest pest mosquitoes, Aedes sollicitans and Aedes
taeniorhynchus, usually breed in areas along the coast, marshes,
swales and mangrove swamps, which may be flooded by rain or high
tides (not normal tides) for a week or longer. The most plentiful
of any species, these two can fly up to 25 miles.

The Freshwater Swamp Mosquito

Aedes in fir mat us and Aedes atlanticus, which are capable of
carrying California encephalitis, and Aedes vexans, which trans-
mits heart worms in dogs, are found in temporary freshwater pools
and on river plains flooded by heavy rains. Some Psorophora
species are also found in flooded fields, irrigated ditches and
groves, and rain pools.

The malaria mosquito, Anopheles quad ii macula t us, is found in
maple and gum swamps, freshwater marshes and ponds, lime sinks,
flooded fallow fields, drainage ditches and floating exotic plants.
Anopheles crucians is found only in cypress and maple-bay swamps,
fresh marshes and ponds, grassy ditches and borrow pits.

240 • FLORIDA HEALTH NOTES

The Tree-Hole and Air-Plant Mosquito

Where trees and air plants are found in great numbers, Aedes
triseriatus and two Wyemoyia species, mitchellii and vanduzeei,

breed and are found in vexing abundance.

The Intimate Life of the Mosquito

The control of the mosquito can be carried out in many ways but
research can tell what is the best and most economical way to do it.
Improvement in mosquito control has been the direct result of re-
search. The Entomological Research Center was set up by the State
Board of Health 12 years ago to further research and control.

Much needs to be known about the insect to be controlled. Un-
fortunately, because of her widespread movement, only a small
fraction of the female mosquito's life has been known in the past —
mostly about her birth and the moment she bites you. How much
knowledge of the intimate life of the mosquito — where she goes,
where she feeds, mates and lays her eggs — has been acquired, but
more needs to be known to bring her under man's control.

Mosquitoes are first studied in their natural habitat. These field
studies bring out what needs to be clarified and verified in the
laboratory. Through the raising of captive mosquito colonies, the
process is refined. Problems are then brought back to the field for
experiment and study in nature. I

Out of this interplay between field and laboratory comes an im-
proved understanding of the mosquito's total natural history. The
mosquito is as complicated a creature as man and studies of the
whole insect need the inclusion of such areas as endocrinology and
metabolism before a complete understanding is reached.

This research is carried on in four sections at the famous En-
tomological Research Center in Vero Beach.

The Ethology Section studies the life histories and habits of the
mosquito. Among the special projects undertaken is a study of
salt-marsh mosquito migration. The breeding, emerging and exodus

FLORIDA HEALTH NOTES • 241

Mosquitoes are
marked prior to being
r e I e a s e d from the
rearing pens of the
Entomological
Research Center.

of the mosquito from the marsh is well understood, but the actual
migratory flight occurs only at night which makes its study dif-
ficult. The final distribution of marked salt marsh mosquitoes has
been determined but the scientists are attempting to learn the whys
and wherefores of long and short migrations.

You may think that mosquitoes will bite anything in sight.
Studies are being made to find out whether certain kinds of animals
attract certain mosquitoes. Blood specimens from engorged mos-
quitoes caught in the wild are matched with blood samples from
birds and animals captured in the same area to see if any real
preferences exist. It is also important to know the flight habits of
the female once she has had a blood meal, and the type of shelter
she seeks in which to rest.

242

FLORIDA HEALTH NOTES

The Ecology Section is concerned with the mosquito's environ-
ment and the effects of weather, tides, vegetation, soils and
anything else that influences the mosquito's distribution and
abundance.

The Physiology Section studies the biological functions for a
better understanding of the mosquito's behavior. Inquiries are
being made into why some mosquitoes need blood to make eggs
while others do not. This is tied up with nutrition and hormones
which are also under study. The nutrition studies call for the rear-
ing of larvae with precision methods in controlling temperature,
light and diet.

The Biochemistry Section looks into the metabolic functioning of
the female mosquito — such as what does she do with nectar meals
and blood meals. Answers to such questions as to how long can a
newly-emerged adult fly before needing food, how long can a mos-
quito live without nectar to feed on, and how long can a mosquito
live on its fat reserve have been found in the 'laboratory. Now
the Entomological Research Center needs to establish the answers
in the field.

All of this research is related to control measures. Basic re-
search takes time. The practical, temporary control measures of
applied research are sought at the West Florida Arthropod Re-
search Laboratory near Panama City. At this laboratory, the work
is divided into two sections: mosquito control and control of biting
flies. The scientists look for temporary measures, such as insecti-
cides and land and water management, to control the biting insects.
The application of insecticides in different concentrations and by
different methods is studied to find the effect chemicals have on
the larval stage in swamps and on adults in their resting places.

Temporary measures include:

The use of larvicides to kill mosquitoes in the early stages. These
are applied by air and ground equipment. Applications must be
thorough but heavy vegetation, winds and heat currents place
limitations on this type of control.

FLORIDA HEALTH NOTES • 243

Mosquitoes are
marked prior to being
released from the
rearing pens of the
E ntomologicol
Research Center.

of the mosquito from the marsh is well understood, but the actual
migratory flight occurs only at night which makes its study dif-
ficult. The final distribution of marked salt marsh mosquitoes has
been determined but the scientists are attempting to learn the whys
and wherefores of long and short migrations.

You may think that mosquitoes will bite anything in sight.
Studies are being made to find out whether certain kinds of animals
attract certain mosquitoes. Blood specimens from engorged mos-
quitoes caught in the wild are matched with blood samples from
birds and animals captured in the same area to see if any real
preferences exist. It is also important to know the flight habits of
the female once she has had a blood meal, and the type of shelter
she seeks in which to rest.

242

FLORIDA HEALTH NOTES

The Ecology Section is concerned with the mosquito's environ-
ment and the effects of weather, tides, vegetation, soils and
anything else that influences the mosquito's distribution and
abundance.

The Physiology Section studies the biological functions for a
better understanding of the mosquito's behavior. Inquiries are
being made into why some mosquitoes need blood to make egjfs
while others do not. This is tied up with nutrition and hormones
which are also under study. The nutrition studies call for the rear-
ing of larvae with precision methods in controlling temperature,
light and diet.

The Biochemistry Section looks into the metabolic functioning of
the female mosquito — such as what does she do with nectar meals
and blood meals. Answers to such questions as to how long can a
newly-emerged adult fly before needing food, how long can a mos-
quito live without nectar to feed on, and how long can a mosquito
live on its fat reserve have been found in the laboratory. Now
the Fntomological Research Center needs to establish the answers
in the field.

All of this research is related to control measures. Basic re-
search takes time. The practical, temporary control measures of
applied research are sought at the West Florida Arthropod Re-
search Laboratory near Panama City. At this laboratory, the work
is divided into two sections: mosquito control and control of biting
flies. The scientists look for temporary measures, such as insecti-
cides and land and water management, to control the biting insects.
The application of insecticides in different concentrations and by
different methods is studied to find the effect chemicals have on
the larval stage in swamps and on adults in their resting places.

Temporary measures include:

The use of larvicides to kill mosquitoes in the early stages. These
are applied by air and ground equipment. Applications must be
thorough but heavy vegetation, winds and heat currents place
limitations on this type of control.

FLORIDA HEALTH NOTES • 243

t

The use of ad ul tic idea — applied as diluted mixtures of chemicals
and oil by aircraft, ground blowers or fogging machines — to kill
adult mosquitoes in a specific area. Limitations, such as heavy
canopy of trees, hot ground or wind, can restrict the effectiveness
of these pesticides.

The methods of killing the villainous mosquito are not 100 per
cent effective and there are always some mosquitoes left to assure
more large broods — which also periodically must be destroyed.

Research on the control of chironomid midges, sometimes called
"blind mosquitoes" is carried on at the Midge Control Laboratory in
Winter Haven.

Microbe - The Killer

If mosquitoes were merely biting pests, they would be bad
enough. But the fact that they carry disease is far more important.
There are several arthropod-borne diseases which have proved fatal
to man and animals in Florida, in addition to previously mentioned
yellow fever, dengue fever and malaria but which, in contrast to
these historic three, are still with us. These are the "arbovirus"
encephalitides (sleeping sickness), St. Louis, California, Eastern,
Venezuelan and Western. Another virus, Tensaw, has also been
marked by epidemiologists as a potentially dangerous mosquito-
borne disease.

These viruses are threats to man because the human population
is rapidly spreading into areas which were until recent decades un-
inhabited. Now abounding in drainage ditches, catch basins, arti-
ficial water receptacles and impounded lakes and streams in
addition to natural breeding places of mosquitoes, these areas add
to the mosquito populations where men live.

244 • FLORIDA HEALTH NOTES

■

Suckling mice are
raised in the virology
laboratory for the
testing for arboviruses.

:i

Florida is also strategically located on the eastern flyway of
migratory birds traveling from the Northern and Southern con-
tinents. Some of these birds are thought to be reservoirs of certain
arthropod-borne viruses.

The epidemics of St. Louis encephalitis in the Tampa Bay area
resulted in the establishment of the Encephalitis Research Center
in Tampa which carries out and coordinates studies of arthropod
vectors, vertebrate reservoirs and human and animal hosts of
encephalitis viruses.

FLORIDA HEALTH NOTES

245

The use of adulticides — applied as diluted mixtures of chemicals
and oil by aircraft, ground blowers or fogging machines — to kill
adult mosquitoes in a specific area. Limitations, such as heavy
canopy of trees, hot ground or wind, can restrict the effectiveness
of these pesticides.

The methods of killing the villainous mosquito are not 100 per
cent effective and there are always some mosquitoes left to assure
more large broods — which also periodically must be destroyed.

Research on the control of chironomid midges, sometimes called
"blind mosquitoes" is carried on at the Midge Control Laboratory in
Winter Haven.

Microbe - The Killer

If mosquitoes were merely biting pests, they would be bad
enough. But the fact that they carry disease is far more important.
There are several arthroi>od-bome diseases which have proved fatal
to man and animals in Florida, in addition to previously mentioned
yellow fever, dengue fever and malaria but which, in contrast to
these historic three, are still with us. These are the "arbovirus"
encephalitides (sleeping sickness), St. Louis, California, Eastern,
Venezuelan and Western. Another virus, Tensaw, has also been
marked by epidemiologists as a potentially dangerous mosquito-
borne disease.

These viruses are threats to man because the human population
is rapidly spreading into areas which were until recent decades un-
inhabited. Now abounding in drainage ditches, catch basins, arti-
ficial water receptacles and impounded lakes and streams in
addition to natural breeding places of mosquitoes, these areas add
to the mosquito populations where men live.

244 • FLORIDA HEALTH NOTES

Suckling mice are
raised in the virology
laboratory for the
testing for arboviruses.

Florida is also strategically located on the eastern fly way of
migratory birds traveling; from the Northern and Southern con-
tinents. Some of these birds are thought to be reservoirs of certain

arthropod-borne viruses.

i

The epidemics of St. Louis encephalitis in the Tampa Bay area
resulted in the establishment of the Encephalitis Research Center
in Tampa which carries out and coordinates studies of arthrojiod
vectors, vertebrate reservoirs and human and animal hosts of
encephalitis viruses.

FLORIDA HEALTH NOTES

245

A colony of mosqui-
toes, which have been
raised in captivity, can
be seen in the small
cage. (On opposite
page) A worker places
a pan of pupae in a
large cage where adult
mosquitoes will em-
erge. The clock on the
table regulates the
amount of light the
mosquitoes receive.

Statewide surveillances by the State Board of Health in Florida
include work by

• the Division of Veterinary Public Health, in the Bureau of
Preventable Diseases, which maintains chicken sentinel flocks
around the state to detect any activity of encephalitis viruses and
collects reports from veterinarians of equine encephalomyelitis and
possible encephalitis in game birds;

• the Division of Epidemiology, also in the Bureau of Preventable
Diseases, which collects reports of suspected cases of arthropod-
borne viruses in humans from physicians, hospitals and County
Health Departments ;

• the Bureau of Entomology, which through a group of co-
operators, collects, identifies and measures the density of adult
female mosquitoes, and prepares pools of mosquitoes for viral
studies; and

• the Bureau of Laboratories, which examines human and ani-
mal diagnostic specimens and mosquito pools for arthropod-borne
diseases.

246

FLORIDA HEALTH NOTES

The Viruses

The St. Louis encephalitis virus, which was responsible for three
epidemics in the Tampa Bay area in 1959, 1961 and 1962, involving
some 300 persons and 50 deaths, is still a major threat despite the
fact that it has not been detected in Florida in the past four years.
The reason for this constant threat is that the mosquito C. nigri pal-
pus, which has been declared the vector, is prevalent in both rural
and urban areas of Florida, Migratory birds, or birds from the
Everglades, are presumed to be the reservoirs for this virus. Older
people, who have retired to Florida, have a marked susceptibility to
the disease. Mortality averages one in three cases and survivors
have neurological or emotional defects for two to three years fol-
lowing the illness. St. Louis encephalitis is a milder disease in
younger people. The control of this disease is important to our
tourist-oriented economy.

1

FLORIDA HEALTH NOTES

247

A colony of mosqui-
toes, which hove been
raised in captivity, can
be seen in the small
cage. (On opposite
page* A worker places
a pan of pupae in a
large cage where adult
mosquitoes will em-
erge. The clock on the
table regulates the
omount of tight the
mosquitoes receive.

Statewide surveillances by the State Board of Health in Florida
include work by

• the Division of Veterinary Public Health, in the Bureau of
Preventable Diseases, which maintains chicken sentinel flocks
around the state to detect any activity of encephalitis viruses and
collects reports from veterinarians of equine encephalomyelitis and
possible encephalitis in game birds;

• the Division of Epidemiology, also in the Bureau of Preventable
Diseases, which collects reports of suspected cases of arthropod-
borne viruses in humans from physicians, hospitals and County
Health Departments;

• the Bureau of Entomology, which through a group of co-
operatnrs, collects, identifies and measures the density of adult
female mosquitoes, and prepares pools of mosquitoes for viral
studies; and

• the Bureau of Laboratories, which examines human and ani-
mal diagnostic specimens and mosquito pools for arthropod-borne
diseases.

246

FLORIDA HEALTH NOTES

The Viruses

The St. Louis encephalitis virus, which was responsible for three
epidemics in the Tampa Bay area in 1959, 19(31 and 1902, involving
some 300 persons and 50 deaths, is still a major threat despite the
fact that it has not been detected in Florida in the past four years.
The reason for this constant threat is that the mosquito C. nigripal-
pus, which has been declared the vector, is prevalent in both rural
and urban areas of Florida. Migratory birds, or birds from the
Everglades, are presumed to be the reservoirs for this virus. Older
people, who have retired to Florida, have a marked susceptibility to
the disease. Mortality averages one in three cases and survivors
have neurological or emotional defects for two to three years fol-
lowing the illness. St. Louis encephalitis is a milder disease in
younger people. The control of this disease is important to our
tourist-oriented economy.

FLORIDA HEALTH NOTES

247

1

A battery of tests is performed in order to isolate and identify arboviruses
in Hie Encephalitis Research Center's virology laboratory.

248

FLORIDA HEALTH NOTES

Eastern encephalitis is with us all of the time and appears to
circulate in a certain type of swamp mosquito, Culiseta melanura.
This inseet rarely bites man or mammals unless they wander too
close to the swamps. Seven persons have been stricken in the last
two years with this disease which has a 50 to 70 per cent mortality
rate in national statistics. Although a vaccination for horses has
been developed, there are an average of 100 equine cases caused by
Eastern encephalitis each year. The virus also damages flocks of
game birds, particularly pheasants and chukars — a type of
partridge. The virus apparently stays localized in swamps but with
housing projects being built closer to these areas, the danger to
man is increasing.

California encephalitis is a newcomer to Florida and was not
recognized prior to 1963. Four Florida persons (three of whom
came from North Carolina after exposure there) have been at-
tacked by the virus. Epidemics have occurred in Wisconsin, Ohio
and Indiana during the last five years. Surveys s"how that five to
six per cent of Florida's population have antibodies which indicate
that they have been infected sometime in the past. The mystery is :
Why are not more people ill with the disease ? The answer is possi-
bly because laboratory tests sensitive enough to detect the virus
have not been found. Mammals, such as small ground squirrels and
wild rabbits, have been reported as reservoirs for the virus in other
parts of the United States but it is not known what the reservoir
is in Florida. The vector mosquitoes are freshwater Aedes, and
California virus has been found in them throughout the state.

The Venezuelan encephalitis is found repeatedly in the Ever-
glades by teams from the U. S. Public Health Service. The virus
appears to circulate constantly between mosquitoes and small
rodents. About 27 per cent of the Seminole Indians, and a small
number of rangers from the Everglades National Park, have anti-
bodies which indicate they have been infected. Carried by the
pest mosquito, A. taeniorhynchus, the virus produces widespread
epidemics in Central and South America. Symptoms are similar to
influenza. If the virus ever got into Florida's plentiful salt marsh

FLORIDA HEALTH NOTES • 249

*

A battery of tests is performed in order to isolate and identify arboviruses
in the Encephalitis Research Center's virology laboratory.

248

FLORIDA HEALTH NOTES

Eastern encephalitis is with us all of the time and appears to
circulate in a certain type of swamp mosquito, Culiseta melanura.
This insect rarely bites man or mammals unless they wander too
close to the swamps. Seven persons have been stricken in the last
two years with this disease which has a 50 to 70 per cent mortality
rate in national statistics. Although a vaccination for horses has
been developed, there are an average of 100 equine cases caused by
Eastern encephalitis each year. The virus also damages flocks of
game birds, particularly pheasants and chukars — a type of
partridge. The virus apparently stays localized in swamps but with
housing projects being built closer to these areas, the danger to
man is increasing.

California encephalitis is a newcomer to Florida and was not
recognized prior to 1963. Four Florida persons (three of whom
came from North Carolina after exposure there) have been at-
tacked by the virus. Epidemics have occurred in Wisconsin, Ohio
and Indiana during the last five years. Surveys s'how that five to
six per cent of Florida's population have antibodies which indicate
that they have been infected sometime in the past. The mystery is :
Why are not more people ill with the disease? The answer is possi-
bly because laboratory tests sensitive enough to detect the virus
have not been found. Mammals, such as small ground squirrels and
wild rabbits, have been reported as reservoirs for the virus in other
parts of the United States but it is not known what the reservoir
is in Florida. The vector mosquitoes are freshwater Aedes, and
California virus has been found in them throughout the state.

The Venezuelan encephalitis is found repeatedly in the Ever-
glades by teams from the U. S. Public Health Service. The virus
appears to circulate constantly between mosquitoes and small
rodents. About 27 per cent of the Seminole Indians, and a small
number of rangers from the Everglades National Park, have anti-
bodies which indicate they have been infected. Carried by the
pest mosquito, A. taeniorhynchus, the virus produces widespread
epidemics in Central and South America. Symptoms are similar to
influenza. If the virus ever got into Florida's plentiful salt mai sh

FLORIDA HEALTH NOTES • 249

;ction

The best method of preventing mosquito biting ond possible infe
is to;

• use repellents,

• weor protective clothing,

• avoid areas and times of mosquito activity (mostly at dusk or
dawn) and

• get rid of standing water (breeding places) around your home

mosquito, public health authorities would have a major problem
on their hands.

Western encephalitis has been found consistently in Florida since
1960. Antibodies in birds show that it is present in the biological
environment but to date the only mammals involved have been
horses. In the Great Plains and the West, the virus has caused a
great deal of sickness in humans and horses.

Lesser Microbes

The Tensaw virus, found in Anopheles mosquitoes, is presumed
to have a mammal-mosquito cycle. Only one human case has been
found in Florida despite the fact that it is abundant throughout
the state and antibodies are found in three to five per cent of the
population. The virus was also found in a dead fox submitted for
rabies studies. It does not appear to present a human or animal
health problem at the present time.

Yellow fever and dengue fever have ceased to be a threat to
Florida although they are found in the Caribbean Islands. Yellow
fever was last seen in Pensacola in 1905 and dengue made its last
appearance in Miami and the Tampa Bay area in 1934. However,
in 1964, two Florida residents came down with dengue fever after
returning from Puerto Rico and Jamaica where epidemics were
raging. The last case of malaria was contracted in southwest Flor-
ida in 1948.

250

FLORIDA HEALTH NOTES

Surveillance for Viruses

Utilizing reports from physicians, hospitals and County Health
Departments in the Tampa Bay area, the Encephalitis Research
Center keeps a watch over people and animals in the West Central
area of the peninsula. Approximately 1600 persons have been
screened for arthropod-borne diseases in the last four years. Be-
cause the viruses do not always produce illnesses in people, speci-
mens are taken from approximately 400 healthy persons in the
Tampa Bay area once a year to see if they have developed silent
infections or antibodies.

Mosquitoes are collected at regular intervals from various kinds
of traps geographically scattered throughout Pinellas, Hills-
borough, Manatee and Sarasota Counties. Over one million mos-
quitoes have been trapped in the past four years and all species have
been examined for viruses. The mosquitoes are separated into
species and then separated by sexes. The females are put into paols
of 50 and 100 mosquitoes, which are mixed together and inoculated
into baby mice. If the mice become sick and die, the virus is be-
lieved to be present. If subsequent tests are positive, the viruses
are isolated and identified. Seven viruses can be identified in the
Encephalitis Research Center's virology laboratory; other types
are sent to the U. S. Public Health Service, Communicable Dis-
ease Center laboratories, Atlanta, a national laboratory at the
University of Pittsburgh, or the international laboratory at Yale
University. In the past four years, three previously unknown
viruses have been discovered in Florida in ticks, mosquitoes and
cotton rats through the efforts of the Encephalitis Research Cen-
ter.

Biologists at the Center in Tampa attempt to detect current and
past virus infections in mammals, birds and amphibians. Chickens,
rabbits and pigeons have been placed in cages in wild areas to detect
arboviruses in wild mosquitoes. Wild animals and both resident
and migratory birds are collected, bled, tagged and released. No
harm is done to the birds and sometimes the same bird is caught
repeatedly. Over a period of three years one small bird was caught
and bled 18 times without harm by the biologists. The blood

FLORIDA HEALTH NOTES

251

samples from these animals and birds are examined for the
presence of virus or antibodies to viral infections.

The State Board of Health, through its various bureaus and
divisions, continues to look for ways of interrupting the trans-
mission of viruses in the mosquito-bird-man cycle. This seems to
be the most practical way of protecting the citizens of Florida from
encephalitis.

What Mosquito Control Means to Florida

One of the most important key factors to the expansion of the
Florida economy is mosquito control. Such men as Henry Flagler
and H. B. Plant, who came to Florida with money to invest, looked
to the State Board of Health for proper sanitary regulations that
assisted in the building of hotels and the vast railroad systems.
I Today's tourist industry takes it for granted that the State Board

of Health and the local mosquito control districts will not let it
down by permitting either mosquitoes or the diseases they carry to
take the state over again and keep it in chains as they once did.

t

There is no question that control of the mosquito helped open up
the state to the planting of citrus, mining of phosphate, cutting of
virgin pine and cypress and the starting of the cattle industry.
Most of all, the control of arthropods and arthropod-borne diseases
opened subtropical Florida to people from all over the United States
and the world who come to enjoy the climate, good fishing, excel-
lent beaches and unsurpassed beauty.

The State Board of Health, mosquito control districts and the
Boards of County Commissioners are spending approximately $8
million annually for control of mosquitoes and other forms of
arthropods. Fifty-seven mosquito control districts, operating in
54 of the 67 counties, applied in one year over three million gallons
of insecticide formula by air and ground fogging and spraying to

252 • FLORIDA HEALTH NOTES

1

W\

VJ- M

M j V.i

jB

^Tj^B

/ •>

•V*i^ 1

H » /y

k^' W

V ,

If I * *l

.»

R' :

^^^

/ M

^^

A rabbit (11, which has been used
as bait to attract mosquitoes, is

1/

r^

i*

T'

/

.

removed from a trap in a swampy

area. (2 1 Mosquitoes, which are

sucked by a voccum into a bog

before they can attack the rabbit.

are removed from the trap. (3)

The entomologist checks the

operations of a tent trap.

3

kill adults and over 723,000 pounds of Paris green pellets to kill
larvae. Over three million acres were treated by airplanes and over
389,000 miles were traveled by ground fogging machinery. By

FLORIDA HEALTH NOTES

253

samples from these animals and birds are examined for the
presence of virus or antibodies to viral infections.

The State Board of Health, through its various bureaus and
divisions, continues to look for ways of interrupting the trans-
mission of viruses in the mosquito-bird-man cycle. This seems to
be the most practical way of protecting the citizens of Florida from
encephalitis.

What Mosquito Control Means to Florida

One of the most important key factors to the expansion of the
Florida economy is mosquito control. Such men as Henry Flagler
and H. B. Plant, who came to Florida with money to invest, looked
to the State Board of Health for proper sanitary regulations that
assisted in the building of hotels and the vast railroad systems.
Today's tourist industry takes it for granted that the State Board
of Health and the local mosquito control districts will not let it
down by permitting either mosquitoes or the diseases they carry to
take the state over again and keep it in chains as they once did.

There is no question that control of the mosquito helped open up
the state t'j the planting of citrus, mining of phosphate, cutting of
virgin pine and cypress and the starting of the cattle industry.
Most of all, the control of arthropods and arthropod-borne diseases
opened subtropical Florida to people from all over the United States
and the world who come to enjoy the climate, good fishing, excel-
lent beaches and unsurpassed beauty.

The State Board of Health, mosquito control districts and the
Boards of County Commissioners are spending approximately ?8
million annually for control of mosquitoes and other forms of
arthropods. Fifty-seven mosquito control districts, operating in
54 of the 67 counties, applied in one year over three million gallons
of insecticide formula by air and ground fogging and spraying to

252 • FLORIDA HEALTH NOTES

kill adults and over 723,000 pounds of Paris green pellets to kill
larvae. Over three million acres were treated by airplanes and over
389,000 miles were traveled by ground fogging machinery. By

FLORIDA HEALTH NOTES

253

contrast, 15 years ago, the State Board of Health and other agencies
spent about one million dollars for arthropod control.

It is apparent that time, effort and money expended in con-
trolling the mosquito and the diseases it carries have brought
results. But further research and control are necessary. The State
Board of Health must maintain protection against mosquitoes and
increase its strides in research in order to protect the health and
comfort of Florida residents and tourists.

Definitions for Some Terms We Used

Adulticide — an insecticide or pesticide which kills adult insects.
Antibody — a factor (globulin) in the body which is produced by a past

infection or the administration of an antigen, such as a vaccine.
Arbovirus — an infectious agent carried by arthropods.
Arthropod — a member of a group of in vertebra ted creatures with

jointed legs and segmented bodies; insects, ticks, etc.
Arthropod -borne diseases — diseases carried by any one member of the

arthropod family.
Encephalitis — an inflammation of the brain often caused by the

presence of a virus, which may be arthropod -borne, sometimes

called sleeping sickness.

Endocrinology — the study of hormones and their effect on the body.

Larvicide — a chemical which kills insect larvae.

Metabolism — the chemical process by which food is burned in the body

to release energy.
Microbes — a microorganism (for example, virus, bacteria, rickettsial

which may cause disease.
Reservoir — a creature or animal in which a virus lives and multiplies

without doing damage to the host.
Vector — an agent, such as a mosquito, capable of transmitting a

disease from one host to another.
Virus — a submicroscopic infectious agent which can cause disease.

i

254

FLORIDA HEALTH NOTES

11^

IDA ST&3L

rtmoAov

contrast, 15 years ago, the State Board of Health and other agencies
spent about one million dollars for arthropod control.

It is apparent that time, effort and money expended in con-
trolling the mosquito and the diseases it carries have brought
results. But further research and control are necessary. The State
Board of Health must maintain protection against mosquitoes and
increase its strides in research in order to protect the health and
comfort of Florida residents and tourists.

f«

Definitions for Some Terms We Used

Adulticide — an insecticide or pesticide which kills adult insects.
Antibody — a factor (globulin) in Hie body which is produced by a past

infection or the administration of an antigen, such as a vaccine.
Arbovirus — an infectious agent carried by arthropods.
Arthropod — a member of a group of invertebrated creatures with

jointed legs and segmented bodies; insects, ticks, etc.

Arthropod borne diseases — diseases carried by any one member of the
arthropod family.

Encephalitis — an inflammation of the brain often caused by the

presence of a virus, which may be arthropod-borne, sometimes

called sleeping sickness.
Endocrinology — the study of hormones and their effect on the body.
Larvicide — a chemical which kills insect larvae.
Metabolism — the chemical process by which food is burned in the body

to release energy.
Microbes — a microorganism (for example, virus, bacteria, rickettsial

which may cause disease.
Reservoir — a creature or animal in which a virus lives and multiplies

without doing damage to the host.
Vector — an agent, such as a mosquito, capable of transmitting a

disease from one host to another.
Virus — a submicroscopic infectious agent which can cause disease.

„— $

254

FLORIDA HEALTH NOTES

imu ^^ m ^ k

( Cover photo I Maternal and
child core has been at the heart
of Florida's public health
program for many years. Five
new Maternal and Infant Care
projects, covering 40 per cent of
the population with intensive
care for high risk, indigent, ex-
pectant mothers and their chil-
dren are located in the «tate.

The State Board of Health and
County Health Departments car-
ry on a wide range of programs
in Florida. Some of them are
dental health, school health,
family planning, water pollution,
food hygiene, radiological health,
air pollution, migrant labor and
medical care for Seminole and
Miccosukee Indians.

Year of Change: 1966

The year of 1966 will go down in Florida's public health history
as a year of change, a year of new horizons and a year of ac-
complishments.

Following a custom of long standing, this June issue of Florida
Health Notes is devoted to a review of the State Board of Health's
Annual Report for the previous year. The original report con-
tains over 10 times as many pages as does this magazine; we,
therefore, will make no pretense of cramming a comprehensive
condensation of that document into these pages. Leaving the rou-
tine, the technical, the prosaic to be found in the larger document,
we will seek out the highlights, the new and the most important
for inclusion here.

Public health, marching beside private medicine, has conquered
enemy after enemy in a few short decades. To our grandparents
public health meant almost futile battles against deadly plagues
and the grossest of sanitary abuses. Today, with polio gone, the
great killer fevers are mere fractions of what they were, and
public sanitation the rule rather than the exception. Public health
means prevention of birth defects — or of too many unwanted
births ; rehabilitation for stroke victims ; screening for eye, ear and
dental defects in schools; and immunizations for small children.
Eradication of diseases, such as measles, is talked of as a goal —
not a dream.

But the social diseases are creeping ahead in a changing society;
stubborn old tuberculosis still fights hard to hold its own. Cancer,
heart, lung and vascular diseases, and accidents now threaten the
lives of many people who in earlier times would have died of com-
municable diseases at a younger age.

So, in 1966, the administration of Medicare, the development of
five new Maternal and Infant Care projects, the stubborn resist-

FLORIDA HEALTH NOTES • 259

i

ance of venereal diseases and the increasing concern over water
and air pollution kept the state and county official health agencies
busy.

"The year saw the beginning of a trend that may result in sweep-
ing changes in public health practices," said State Health Officer
Wilson T. Sowder, M.D. He pointed out that the "new or expanded
programs involving comprehensive care" call for new relationships
with physicians, dentists, hospitals and other agencies. He saw
more disciplines, such as social service, coming into the picture,
recruitment and training problems to be solved, and a greater
responsibility upon the shoulders of all public health workers.

Mothers and Children

Mothers and babies have always been at the heart of the broad
public health program of the state and nation. In Florida this year
even greater attention was being paid to them. The Maternal and
Infant Care programs, in which high risk mothers-to-be were taken
under close and costly surveillance, provided full and complete medi-
cal care for indigent mothers and infants. In the predictable de-
crease of retardation and malformation alone, these programs will
pay their way. The effect on families relieved of the burden of
caring for imperfect children is incalculable.

The program to promote family planning is underway in all but
one county. The distribution of contraceptive information and
specific aids has, nevertheless, reached only a tiny fraction of the

FLORIDA HEALTH NOTES

Published monthly by the Florido Stote Board of Health, Wilson T. Sowder, M.D., M.P.H.,
State Health Officer. Publication office. Box 210, Jacksonville, Florido 32201. Second class
postage paid at Jacksonville, Florida. This publication is for individuals and institutions with
on interest in the state's health programs. Permission is given to quote ony story providing
credit is given to the Florida State Board of Health. Editor: Robert A. Schoonover, M.A.,
Division of Health Education

VOLUME 59— NO 6

JUNE 1967

260

FLORIDA HEALTH NOTES

A laboratory technician
reads a PKU test in the
search for potentially re-
tarded infants. This pro-
gram was set up in the
State Board of Health fol-
lowing the 1965 Legisla-
tive session and now
reaches some 70 per
cent of infants born in
Florida.

women who need these benefits. A vast program of education and
motivation is just beginning.

Hospitals were the birthplace of 97 out of every 100 children
born in Florida this year. But the lack of fathers cast a social
shadow over more than 13,000 of them, while nearly 4000 new
mothers were under 17 years of age. However, in spite of the
trend toward younger motherhood, there were only 40, or one-
third fewer maternal deaths than 10 years ago. Florida welcomed
102,542 tiny new citizens of whom 27 of every 1000 died in in-
fancy. This is a new low mark. Authorities were still not satisfied
with the rates of immaturity and stillbirth. But the efforts to
bring all newborn infants under phenylketonuria (PKU) testing
ran about 70 per cent of the total births. Meanwhile, for all
mothers, the increased day care facilities and number of home
health aides made life look brighter when trouble came.

For its children Florida did much. The many Headstart Pro-
grams were designed by the Office of Economic Opportunity to
give underprivileged preschoolers a chance to catch up with other

FLORIDA HEALTH NOTES

261

ance of venereal diseases and the increasing concern over water
and air pollution kept the state and county official health agencies
busy.

"The year saw the beginning of a trend that may result in sweep-
ing changes in public health practices," said State Health Officer
Wilson T. Sowder. M.D. He pointed out that the "new or expanded
programs involving comprehensive care" call for new relationships
with physicians, dentists, hospitals and other agencies. He saw
more disciplines, such as social service, coming into the picture,
recruitment and training problems to be solved, and a greater
responsibility upon the shoulders of all public health workers.

Mothers and Children

Mothers and babies have always been at the heart of the broad
public health program of the state and nation. In Florida this year
even greater attention was being paid to them. The Maternal and
Infant Care programs, in which high risk mothers-to-be were taken
under close and costly surveillance, provided full and complete medi-
cal care for indigent mothers and infants. In the predictable de-
crease of retardation and malformation alone, these programs will
pay their way. The effect on families relieved of the burden of
caring for imperfect children is incalculable.

The program to promote family planning is underway in all but
one county. The distribution of contraceptive information and
specific aids has, nevertheless, reached only a tiny fraction of the

FLORIDA HEALTH NOTES

Published monthly by the Florida Store Board of Health. vviison T. Sawder. M.D., M.P.H.,
State Health Officer Publication office, Box 210. Jacksonville. Florida 32201 Second class
postage paid at Jacksonville, Florida. This publico? on is for individuals and institutions with
on interest in the state's health programs Permission is given to quote any story providing
credit i% given to the Flondo State Board of Health, Ed. tor Robert A Schoonovcr, M.A.,
Oi vision of Health Education.

VOLUME S9 — NO. 6 JUNE 196T

260 • FLORIDA HEALTH NOTES

A laboratory technician
reads a PKU test in the
search for potentially re-
tarded infants. This pro-
gram was set up in the
State Board of Health fol-
lowing the 1965 Legisla-
tive session and now
reaches some 70 per
cent of infants born in
Florida.

women who need these benefits.
motivation is just beginning.

A vast program of education and

Hospitals were the birthplace of 97 out of every 100 children
born in Florida this year. But the lack of fathers cast a social
shadow over more than 13,000 of them, while nearly 4000 new
mothers were under 17 years of age. However, in spite of the
trend toward younger motherhood, there were only 40, or one-
third fewer maternal deaths than 10 years ago. Florida welcomed
102,542 tiny new citizens of whom 27 of every 1000 died in in-
fancy. This is a new low mark. Authorities were still not satisfied
with the rates of immaturity and stillbirth. But the efforts to
bring all newborn infants under phenylketonuria (PKU) testing
ran about 70 per cent of the total births. Meanwhile, for all
mothers, the increased day care facilities and number of home
health aides made life look brighter when trouble came.

For its children Florida did much. The many Headstart Pro-
grams were designed by the Office of Economic Opportunity to
give underprivileged preschoolers a chance to catch up with other

FLORIDA HEALTH NOTES

261

youngsters in social behavior, kindergarten subjects and health.
Much medical and nursing assistance was given the programs by
the County Health Departments. Agricultural migrant youngsters
were included where possible.

Florida children received many thousands of vision, hearing and
dental screenings. Parents of those needing correction were re-
ferred to private physicians and those who were underprivileged
were sent to official or voluntary health agencies.

Expanding Nursing Services

The year saw a great demand for public health nurses. The
Maternal and Infant Care projects and the 57 local agencies
handling outpatient Medicare cases can pay somewhat higher

Medicare brought
home nursing core
to many of Flori-
da's elderly persons.
Twelve of the 59
home health service
agencies which op-
erate under Medi-
care provide such
care with home
health aides.

salaries than the County Health Departments, thus increasing the
problem for these latter agencies. The workload increased for the
regular staff nurses because there was so much to be done in train-
ing home health aides and in the work of adjusting present organi-
zational structures to the new programs.

262

FLORIDA HEALTH NOTES

The state's midwives continue to decrease in number and to in-
crease in professional stature. Only 168 of the several hundred
who were licensed a decade ago remain active. They constantly
attend training sessions to upgrade their practice. Eleven counties
now have no midwives at all. This reflects the trend toward hospital
delivery of babies at all economic levels.

Agricultural Migrant Laborers

Migrant camp improvements and health surveillance continued
as in years past but the knotty problem of continuity of care from
state to state moved closer to solution. Some 2000 migrants re-
ceived this service as interstate understanding, cooperation and
methods improved.

Narcotics

Narcotic inspectors found 12 cases involving the misuse of LSD
by irresponsible persons^— and no state law to cover them. They
went to federal courts; the Legislature has been advised of the
situation.

The bureau expressed alarm over the steady increase in the
abuse of barbiturates and amphetamines, and promised an increas-
ing educational effort in this field. Its report indicated a marked
decrease in the number of health professionals involved in narcotic

matters.

Arthropods and Arboviruses

The state and federal governments spent $3,500,000 on the pro-
gram to inspect a million Florida homes for Aedes aegypti mosquito,
the one that carries yellow fever and breeds around human habita-
tions. They found 19,000 places needed anti-mosquito treatment.
Meanwhile another $8,000,000 from state and local sources went
into dredging, ditching, impounding, flooding, draining, spraying,
fogging, dusting, pelleting and other measures to control the pests

FLORIDA HEALTH NOTES • 263

\i

II

II

1 1

-i 1 1

i

$tir

-1

m*

.m-^

I '

l|

Did you recognize this as a hospital? It is. Florida has 54 packaged
hospitals strategical I y located and stored around the state ready
to be unpacked. They will provide a disaster-stricken community
with a complete 200-bed facility.

that annoy tourists and natives and carry many diseases, including
the various arboviruses.

An increase was noted in the number of unlicensed pest control
operators. Their operations are illegal and the public was asked to
report solicitations by unauthorized persons to the police. The law
requires the name and Florida business address of the company to
show plainly on the truck.

Florida's Encephalitis Research Center, set up four years ago in
Tampa after an epidemic there, is going strong. Its scientists found
no cases of St. Louis encephalitis in 1966, but found a number of

2*4

FLORIDA HEALTH NOTES

encephalitis viruses in birds and animals, ready to be carried by
mosquitoes to humans.

Health Education

The State Board of Health library increased to about 23,000 vol-
umes of books and bound journals. The audio- visual staff sent out
more than 12,000 films to schools and organizations; close to half
a million pamphlets were distributed; the average issue of Florida
Health Notes went to 21,000 a month; and radio and television
health announcements were dispatched to the state's stations regu-
larly throughout the year. Exhibits numbered 44, with 558 other
visual pieces, ranging from speakers' name plates to large wall
charts, made.

Dental Health

"Serious understaffing crippled the work with indigent children,"
states the report of the Bureau of Dental Health. Mobile units
stood idle waiting for dentists and hygienists to operate them in
areas where no dentist was practicing. But on the brighter side,
39 dental clinics were operated in County Health Departments ; the
number of cities with fluoridated water rose to 35 — thus giving
a million persons this great benefit. The program to educate
dentists in identifying signs of oral cancer paid off with 17 such
discoveries. Other patients are still under diagnosis.

Preventing Accidents

Experts studied auto crash injuries, poison control education,
snake bites and drownings during the year. Certification of
ambulance drivers and attendants saw 1001 persons approved after
receiving first aid training. The Medical Self-Help courses, which
teach first aid and survival in disaster where no medical aid is
available, have reached 95,000 persons to date.

!

FLORIDA HEALTH NOTES • 265

, i

Did you recognize this as a hospital? It is. Florida has 54 packaged
hospitals strategically located and stored around the state ready
to be unpacked. They will provide a disaster-stricken community
with a complete 200-bed facility.

that annoy tourists and natives and carry many diseases, including
the various arboviruses.

An increase was noted in the number of unlicensed pest control
operators. Their operations are illegal and the public was asked to
report solicitations by unauthorized persons to the police. The law
requires the name and Florida business address of the company to
show plainly on the truck.

Florida's Encephalitis Research Center, set up four years ago in
Tampa after an epidemic there, is going strong. Its scientists found
no cases of St. Louis encephalitis in 1966, but found a number of

264

FLORIDA HEALTH NOTES

encephalitis viruses in birds and animals, ready to be carried by
mosquitoes to humans.

Health Education

The State Board of Health library increased to about 23,000 vol-
umes of books and bound journals. The audio-visual staff sent out
more than 12,000 films to schools and organizations; close to half
a million pamphlets were distributed; the average issue of Florida
Health Notes went to 21,000 a month; and radio and television
health announcements were dispatched to the state's stations regu-
larly throughout the year. Exhibits numbered 44, with 558 other
visual pieces, ranging from speakers' name plates to large wall
charts, made.

Dental Health

"Serious understating crippled the work with indigent children,"
states the report of the Bureau of Dental Health. Mobile units
stood idle waiting for dentists and hygienists to operate them in
areas where no dentist was practicing. But on the brighter side,
39 dental clinics were operated in County Health Departments ; the
number of cities with fluoridated wafer rose to 35 — thus giving
a million persons this great benefit. The program to educate
dentists in identifying signs of oral cancer paid off with 17 such
discoveries. Other patients are still under diagnosis.

Preventing Accidents

Experts studied auto crash injuries, poison control education,
snake bites and drownings during the year. Certification of
ambulance drivers and attendants saw 1001 persons approved after
receiving first aid training. The Medical Self-Help courses, which
teach first aid and survival in disaster where no medical aid is
available, have reached 95,000 persons to date.

FLORIDA HEALTH NOTES • 265

OUR 75th Al

With this month, FLORIDA HEALTH NOTES Shortage of personnel, |

observes its 75th year. In June of 1892, the three- for not publishing,
year-old Florida State Board of Health brought Jo «ph Y. Porter, Ml

out a BULLETIN as its official publication. The Officer, stared in the s

next issue (July 1892) the booklet was given the senting this little phomp

..... . ,. of Florida, the hope is

name which tt bears today. It was printed until „- , ,.«""*".

,,w, t l.- - the meons of stimulotm

& 1900 when publication was suspended. A new _»____. _„* ^ i j.

f manners, not only wim

I series was started in 1906 and the booklet has wi| | arouse fhose who fl

been in continuous publication since then except tection of the public li

for the period February 1919 to March 1922. active measures "

I

Laboratory Services

Florida's public health laboratories made more than 2,700,000
tests for doctors, dentists, veterinarians, engineers and other per-
sons needing scientific analysis of specimens or other materials.
A brand new building in Tampa replaced the ancient, small edifice
which had housed that regional laboratory since 1910. It was named
for Homer Venters who had directed the laboratory activities
there for 48 years, and who at his death in 1965, had served the
State Board of Health for 50 years.

Chronically III and Aged

Heart disease remained the state's number one killer. Emphyse-
ma and chronic bronchitis death rate more than doubled in the
past 10 years to become one of the leading causes of death. Both
conditions were linked to smoking, which the State Board of
Health, through affiliation with the Florida Committee on Smoking
and Health, fought vigorously with all the educational means at
its command.

266 • FLORIDA HEALTH NOTES

,#,&. ^w^^^^^«^^^«^*-^'^"-'^li^'t^^^»^>c^i'^*^Tt^x^x^-^^-.^i l ^»^» s ^K^:t^i-^~ l ^

mVERSARY

s and time were reasons

the first State Health
ond issue that "in pre-

t monthly to the public
pressed that it may be

an interest in sanitary
lie masses, but thot it

charged with the pro-

It h in the counties to

The purposes of FLORIDA HEALTH NOTES have
not changed in the past 75 years but they have
been expanded to include a wider range of health
problems and programs than Dr. Porter ever
dreamed.

The next issue will be devoted to interesting
facts about health from 1892 to 1900— the first
eight years of FLORIDA HEALTH NOTES' ex-
istence.

The 27 tumor clinics, which are affiliated with the Cancer Con-
trol Program, were used as referral centers by Florida physicians.
Highly skilled specialists gave early diagnosis and treatment —
the key to cancer survival. Some 21,000 women were examined
for cervical cancer and over two per cent of this number were re-
ferred for further diagnosis.

A total of 7825 persons received assistance with heart problems.
More than 1200 were given rheumatic fever drugs. Others were
served by the clinics which were staffed by specialists who served
without charge, and which operated with help from the Florida
Heart Association. Educational activity was carried on to tell the
public that smoking, inactivity, obesity, hypertension and ac-
cumulated cholesterol might contribute to heart disease. Group
therapy for the rehabilitation of stroke victims was tried and found
to be successful.

A Health Profile Screening Program for persons over 35 years
of age was carried on in Charlotte County, a retirement center,

FLORIDA HEALTH NOTES

267

A food processing
plant worker ex-
presses herself at
she receives a tuber-
culin skin test from
a public health
nurse. Thousands of
skin tests and X-ray
films were made in
the search for those
suffering from
tuberculosis.

with interesting results. Of 1824 persons examined, 706 were re-
ferred to their private physicians for health reasons. About 10
per cent were suspected of having- diabetes and 2.5 per cent of
having glaucoma.

One of the state's public health programs is the giving of free
insulin to the indigent diabetics. There were 3309 persons this year
who received this service. Over 32,000 were screened for diabetes
with 1167 referred to physicians for further diagnosis. Fourteen
lay societies were active. They helped to educate diabetics and the
public and conducted a very successful camp for diabetic children.
Timely Topics, a monthly bulletin for those suffering from this
disease, and their families, went to 4000 copies each issue.

268

FLORIDA HEALTH NOTES

'I

Just under 100,000 persons were screened for glaucoma and
1309, over three per cent, found positive. For these, blindness will
be delayed or prevented because they were found in time.

The approval of hospitals and nursing homes for Medicare took
a great deal of time and energy, and involved many technical and
scientific personnel in the health facilities and services programs.
At year's end, 172 of the state's 189 licensed hospitals (94 per
cent of all hospital beds) were approved for participation in Medi-
care. Of 350 nursing homes, 89 were ready to handle Medicare
patients. A total of 57 home health service agencies was approved
to give home nursing care. A new kind of health worker, the home
health aide, had to be trained by the dozen for this work.

Florida's previously existing programs for medical care of per-
sons unable to pay for the services cost around $11,000,000, but
this was a $1,000,000 short of the previous year, due to the shift-
ing of many patients to Medicare.

Communicable Diseases

The Tuberculosis Control Program, one of the oldest in the
state's public health history, saw a change in operation during the
year. Although the number of new cases remained about the
same, another tuberculosis hospital, at Tallahassee, was closed
leaving the state with two where there were five a mere decade
ago. Better casefinding has kept up the influx of new cases but
home care with new drugs has made it possible to discharge the
patient much earlier.

Health authorities discovered a new disease in Orange County.
Several cases of an infection, which they called amoebic encepha-
litis, were found and brought under study and treatment. Four
persons apparently contracted the disease while swimming in fresh-
water lakes.

Measles, a disease which children were obligated to tolerate a
generation ago, is now called dangerous and known to leave mental

FLORIDA HEALTH NOTES • 269

I

A food processing
plant worker ex-
presses herself as
she receives a tuber-
culin skin test from
a public health
nurse. Thousands of
skin tests and X-ray
films were made in
the search for those
suffering from
tuberculosis.

with interesting results. Of 1824 persons examined, 706 were re-
ferred to their private physicians for health reasons. About 10
per cent were suspected of having diabetes and 2.5 per cent of
having glaucoma.

One of the state's public health programs is the giving of free
insulin to the indigent diabetics. There were 3309 persons this year
who received this service. Over 32,000 were screened for diabetes
with 1167 referred to physicians for further diagnosis. Fourteen
lay societies were active. They helped to educate diabetics and the
public and conducted a very successful camp for diabetic children.
Timely Topics, a monthly bulletin for those suffering from this
disease, and their families, went to 4000 copies each issue.

268

FLORIDA HEALTH NOTES

Just under 100,000 persons were screened for glaucoma and
1309, over three per cent, found positive. For these, blindness will
be delayed or prevented because they were found in time.

The approval of hospitals and nursing homes for Medicare took
a great deal of time and energy, and involved many technical and
scientific personnel in the health facilities and services programs.
At year's end, 172 of the state's 189 licensed hospitals (94 per
cent of all hospital beds) were approved for participation in Medi-
care. Of 350 nursing homes, 89 were ready to handle Medicare
patients. A total of 57 home health service agencies was approved
to give home nursing care, A new kind of health worker, the home
health aide, had to be trained by the dozen for this work.

Florida's previously existing programs for medical care of per-
sons unable to pay for the services cost around $11,000,000, but
this was a $1,000,000 short of the previous year, due to the shift-
ing of many patients to Medicare.

Communicable Diseases

The Tuberculosis Control Program, one of the oldest in the
state's public health history, saw a change in operation during the
year. Although the number of new cases remained about the
same, another tuberculosis hospital, at Tallahassee, was closed
leaving the state with two where there were five a mere decade
ago. Better casefinding has kept up the influx of new cases but
home care with new drugs has made it possible to discharge the
patient much earlier.

Health authorities discovered a new disease in Orange County.
Several cases of an infection, which they called amoebic encepha-
litis, were found and brought under study and treatment. Four
persons apparently contracted the disease while swimming in fresh-
water lakes.

Measles, a disease which children were obligated to tolerate a
generation ago, is now called dangerous and known to leave mental

FLORIDA HEALTH NOTES • 269

and physical after effects. With the new vaccine the fed-
eral and state governments are determined to eradicate measles.
Much effort was made during the past year to bring this fact to
public attention. Only the cooperation of every family in the state
can make measles eradication possible.

Venereal diseases in Florida have shown a steady increase for
some years, and only in 1966 was there a tendency to level off
with 1890 primary and secondary syphilis cases.

Environmental Health

The work of environmental health never sounds spectacular. The
work of sanitarians and sanitary engineers is long and hard. It
involves millions of dollars from federal, state and local sources
and when completed is often underground and out of sight. Some
$44,000,000 worth of new or expanded sewerage systems were ap-
proved during the year. About 700 water works, pumping 118
million gallons per day of clean water into Florida homes and cost-
ing over $36,000,000, went into operation.

There were 85 new incinerators built to help take care of solid
waste disposal which is becoming year by year a move serious prob-
lem within the state.

Florida's county sanitarians were kept on the move. They permit-
ted 110,000 trailer spaces in 2523 parks; many were improved over
the previous year with better water and sewer attachments. The
state's 752 food processors were found concentrating on prepack-
aged, ready-to-eat foods. There were 383 camps, mostly for mi-
grants, needing supervision. Some were excellent ; some so poor as
to be condemned for human occupation. Twelve rendering plants
were making fertilizer and animal food from carcasses. Some had
salmonella problems which had to be solved and all plants fought
a constant battle with flies and odors.

Water and food distribution to trains, planes and ships had to
be scrutinized; reports had to be made to the federal agencies.
More than 30,000 food establishments serving food and drink,
packaged or on a plate, had to be visited regularly. Training schools
were held for food service workers.

270 • FLORIDA HEALTH NOTES

Air pollution, such as being produced by this asphalt plant, con-
tinues to be one of the environmental health problems foced by the
State Board of Health.

The state shellfish industry, concentrated in but not confined to
Franklin County, was operated by 166 permitted shellfish houses
employing some 1500 health card holding workers.

Florida sanitary officials have been battling the use of septic
tanks in crowded areas for years. Recent federal regulations, re-
quiring County Health Department approval before septic tanks
could be substituted for central sewerage in federally mortgaged
housing, have helped a lot. Half the new homes in 34 subdivisions
established during the year were put on central sewerage systems.

Radiological and Occupational Health

The radiological and occupational health workers found they had
473 radioactive materials licenses in effect at the year's end. There
were 7697 X-ray machines registered, of which 810 were surveyed
for safety factors. The workers checked air, water and milk
samples for radioactivity. They examined post office trucks, scuba
divers' air supplies and phosphate plants for air impurities. On

FLORIDA HEALTH NOTES

271

and physical after effects. With the new vaccine the fed-
eral and state governments are determined to eradicate measles.
Much effort was made during the past year to bring this fact to
public attention. Only the cooperation of every family in the state
can make measles eradication possible.

Venereal diseases in Florida have shown a steady increase for
some years, and only in 1966 was there a tendency to level off
with 1890 primary and secondary syphilis cases.

Environmental Health

The work of environmental health never sounds spectacular. The
work of sanitarians and sanitary engineers is long and hard. It
involves millions of dollars from federal, state and local sources
and when completed is often underground and out of sight. Some
$44,000,000 worth of new or expanded sewerage systems were ap-
proved during the year. About 700 water works, pumping 118
million gallons per day of clean water into Florida homes and cost-
ing over §36,000,000, went into operation.

There were 85 new incinerators built to help take care of solid
waste disposal which is becoming year by year a more serious prob-
lem within the state.

Florida's county sanitarians were kept on the move. They permit-
ted 110,000 trailer spaces in 2523 parks; many were improved over
the previous year with better water and sewer attachments. The
state's 752 food processors were found concentrating on prepack-
aged, ready-to-eat foods. There were 383 camps, mostly for mi-
grants, needing supervision. Some were excellent ; some so poor as
to be condemned for human occupation. Twelve rendering plants
were making fertilizer and animal food from carcasses. Some had
salmonella problems which had to be solved and all plants fought
a constant battle with flies and odors.

Water and food distribution to trains, planes and ships had to
be scrutinized; reports had to be made to the federal agencies.
More than 30,000 food establishments serving food and drink,
packaged or on a plate, had to be visited regularly. Training schools
were held for food service workers.

270 • FLORIDA HEALTH NOTES

VTF

Air pollution, such as being produced by this asphalt plant, con-
tinues to be one of the environmental health problems faced by the
State Board of Health.

The state shellfish industry, concentrated in but not confined to
Franklin County, was oj>erated by 166 permitted shellfish houses
employing some 1500 health card holding workers.

Florida sanitary officials have been battling the use of septic
tanks in crowded areas for years. Recent federal regulations, re-
quiring County Health Department approval before septic tanks
could be substituted for central sewerage in federally mortgaged
housing, have helped a lot. Half the new homes in 34 subdivisions
established during the year were put on central sewerage systems.

Radiological and Occupational Health

The radiological and occupational health workers found they had
473 radioactive materials licenses in effect at the year's end. There
were 7697 X-ray machines registered, of which 810 were surveyed
for safety factors. The workers checked air, water and milk
samples for radioactivity. They examined post office trucks, scuba
divers' air supplies and phosphate plants for air impurities. On

FLORIDA HEALTH NOTES

271

This little baby is one of
Hie 102,542 infants born
in Florida in the past
year. He is also fortu-
nate in thot he was one
of the 97 out of every 1 00
bom in a hospital.

request, they checked a high school laboratory's liquid mercury for
safe use by the students.

Air and Water Pollution

The twin problems of air and water pollution grew steadily and
received an increased amount of public attention at all levels —
from Washington to the citizen's backyard.

The activity surrounding these problems could not be reported in
dollars or gallons or number of hours spent in serious discussion.
The state and county engineers, sanitarians and chemists devoted
an enormous amount of time in field laboratory examination to
determine the nature and scope of these matters. Scientists, engi-
neers and public officials worked hard with industrial leaders to
try to find ways to continue the manufacturing of necessary prod-
ucts. The quest to add desired multi-million dollar payrolls to the

272

FLORIDA HEALTH NOTES

economy continued; yet it is necessary to do this without spew-
ing noxious fumes and smoke into the air and abominable mix-
tures into the lakes and streams. Many people in both government
and industry consider pollution control as primarily a health
matter and continue to look to the State Board of Health and
County Health Departments for leadership and enforcement of
the provisions of the law which could, with wisdom and prudence,
bring solutions to many of these problems.

Computers in Vital Statistics

With computers doing in hours the calculations that used to take
weeks, giant steps were taken in the processing of vital statistics
and related material. A small reel of tape was prepared to convey
to the Motor Vehicle Bureau in Tallahassee the names of those
licensed drivers who had died during the year. Similar tapes or
stacks of IBM punch cards now carry necessary information
to the Department of Public Welfare, Social Security Administra-
tion and other state and federal agencies. A procedure involving
the sorting of one-half million names that used to take 17 weeks
was carried out this year in 17 hours.

The state recorded 102,542 births, 61,945 deaths, 52,425 mar-
riages (an all time high) and 25,801 divorces. Adoptions at the
rate of 125 a week totaled 5554. The 10 leading causes of death,
in order, were: heart disease, cancer, stroke, accidents, influenza
and pneumonia, diseases of infancy, emphysema, aortic aneurysm,
arteriosclerosis and diabetes.

FLORIDA HEALTH NOTES • 273

i

The Bureau of Vital Statistics disclosed that Florida's population
on July 1, 1966, was 5,941,000, making the state the ninth most
populous, growing at a rate of over two per cent per year since the
1960 census. A population equal to that of Kendry County, 11,300,
has been added to the state every 30 days. Two-thirds of this has
occurred through migration, a large amount of its involving re-
tirees, the remainder representing the difference between births
and deaths. The state is now considered to be 82 per cent white,
with 121/2 per cent of the total population over 65 years of age.

1
1

Personnel and Research

Personnel and recruitments were an increasingly serious prob-
lem during the year because state salaries have not kept pace with
those of industry, the Federal Government and other states. The
need for upper grade technical people and for those in top ad-
ministrative posts continued.

A total of $14,000,000 in federal and state funds went into 42
research and demonstration projects during the year. They ranged
widely in subject matter and involved some 1500 employees. At
the year's end, 18 more such projects had been applied for. In-
cluded in this work were such studies as the long and short range
effects of pesticides on humans, and a sort of "cafeteria" in which
mosquitoes were given a choice of host, or biting place, to see to
what extent they preferred animals, birds or man.

The Important is Often Dull Reading

The above have been a few points of interest taken from the State
Board of Health's Annual Report for 1966.

These points were not' necessarily the most important things
that could have been told because so much of that which is most
important is both routine and dull in telling. The daily work of
physicians, dentists, nurses, sanitarians, vital statistics clerks and
dozens of other technical people goes on day after day and month
after month protecting the public from a myriad of health dangers
and nuisances. These people are dedicated workers. The nature
and arduousness of their tasks are such that mere money would
not attract them to such a calling.

But the people of Florida's public health agencies have had for
the most part a good year and are now well started on what they
hope will be another.

274 • FLORIDA HEALTH NOTES

ACKSONVlLLg^Ha.-

K&.;.

Fi.0Bf&4 STTATF *tn **.«..*

Personnel and Research

Personnel and recruitments were an increasingly serious prob-
lem during the year because state salaries have not kept pace with
those of industry, the Federal Government and other states. The
need fur upper grade technical people and for those in top ad-
ministrative posts continued.

A total of S14.000.000 in federal and state funds went into 42
research and demonstration projects ilui ing the year. They ranged
widely in subject matter and involved some 1500 employees. At

the year's end, IS more such projects had been applied for. In-
cluded in this work were such studies as the long and short range
effects of pesticides on humans, and a sort of "cafeteria" in which
mostj it i toes were given a choice of host, or biting place, to see to
what extent they preferred animals, birds or man.

The Important is Often Dull Reading

The above have been a few points of interest taken from the State
Board of Health's Annual Report for 196G.

These points were not necessarily the most innxntant things
that could have been told Itecause so much of that which is most
important is both routine and dull in telling. The daily work of
physicians, dentists, nurses, sanitarians, vital statistics clerks and
dozens of other technical people goes on day after day and month
after month protecting the public from a myriad of health dangers
and nuisances. These people are dedicated workers. The nature
and arduousness of their tasks are such that mere money would
not attract them to such a calling.

But the people of Florida's public health agencies have had for
the most part a good year and are now well started on what they
hope will be another.

274 • FLORIDA HEALTH NOTES

FLORIDA

HEALTH
NOTES

SONVlLLi, Fla. Hogan

^13- Pa*, and Windsor: Hejtf^

Vi UME 59 " NO 7 Public Health in the 1890s

y i 1967

■

■

: -

■ '

t

■W

Florida was the base for American troops operating in Cuba during the
Spanish -American War in 1898. The State Board or Health was concerned
with diseases soldiers brought back from the Caribbean.

Public Health in the 1890s

Seventy-five years ago last month, June 1892, a fledgling Flor-
ida State Board of Health began publishing a little bulletin to
disseminate reports of the state's health programs and to educate
the people of Florida in the ways of hygiene and sanitation.

That eight-page bulletin was Florida Health Notes. While there
have been many important changes in public health in Florida, the
purposes of our publication have not changed. We are still telling
Floridians about public health programs and the ways to better
health.

Florida Health Notes was published for eight years but because
of lack of time and clerical help, publication ceased until June
1906 when a new series began. The magazine has been published
continuously since that date with the exception of three years
from February 1919 to March 1922.

Because of the break in publication and because of a change
in the public health picture after 1900, this issue of Florida Health
Notes will tell you about public health in those first eight years —
from 1892 to 1900. It was between 1900 and 1906 that public
health officials realized that the mosquito was the carrier of yellow
fever. Disinfection and fumigation, which were believed to be
important in the control of disease, were becoming less important
although they were continued for some time after the period under
discussion.

Public health in the 1890s was concerned primarily with com-
municable diseases and sanitation. The collection of vital statistics,
strongly advocated by the early State Board of Health, was con-

I Cover photo) Sanitation in the cities was one of the major concerns of
the Florida State Board of Health in the 1890s. Long skirts were thought
to carry disease into homes and sweepings from city streets were believed
to contribute to the spread of tuberculosis and diphtheria,

FLORIDA HEALTH NOTES

279

sidered unnecessary by many physicians and laymen. People had
many strange ideas about health and the cause, spread and cure
of disease. But they were doing the best they could with the
knowledge they had at that time. The theory of disease-carrying
germs was new and many people were skeptical of such "new-
fangled ideas."

Communicable diseases were so prevalent that public health
authorities could not be concerned with maternal and child care,
dental health, narcotics, heart disease, cancer and accident pre-
vention, although some of these subjects were mentioned in
Health Notes in those days. Authorities were more concerned with
cesspools under bedroom windows, pigsties too close to homes,
filthy stables and disease-carrying dust.

The basic purpose of public health, as expressed in an early
issue of Health Notes, was to prevent disease and educate the
people.

The Beginning: of Public Health in Florida

The State Board of Health was formed in 1889 following the
1888 yellow fever epidemic in Jacksonville which saw 10,000 per-
sons out of the 26.800 in Duval County flee the area in terror. At
this time there were independent county and city boards of health.
These agencies were more concerned with protecting their own
areas against diseases than in a statewide program and they quar-
antined themselves against everyone who was not "acclimated"
I immunized). But yellow fever and other diseases persisted.

Several attempts by legislatures to form a statewide health
agency failed, but under the direction of Governor Francis P.

FLO* I DA HEALTH MOTES

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280 • FLORIDA HEALTH NOTES

Fleming a special session of the State Legislature was called and
the State Board of Heath was created with Joseph Y. Porter, M.D.,
of Key West as the State Health Officer.

It was Dr. Porter who started Health Notes in 1892 and was
the editor and major contributor during its early years. The in-
formation for this issue is taken from copies of those early Health
Notes now on file in the State Board of Health library.

Preventing Disease

The State Board of Health from the beginning conceived that
its major duty was the prevention of diseases, not just the curing
of them. Through its official publication it continually urged Flo-
ridians to put forth the same protection for their lives that they
did for their property.

Whereas the cure of the sick was the responsibility of physi-
cians, members of the State Board of Health felt that public health
was everybody's medical responsibility. Patients who cooperated
(more or less) in the work of health and the curing of diseases
were not ungrateful to the practitioners of the healing arts. But
those who were in danger of becoming patients did little to fight
to keep disease "from their door." People were known to:

• laugh at bacteria and mock at microbes,

• carry germs of disease in their clothes from house to house,

• sweep up dust of the streets in their trailing skirts,

• take little or no pains to disinfect the excreta from infectious
cases in their homes,

• oppose with influence the erection of hospitals for infectious
diseases,

• impede the efforts of medical officers of health and inspectors
of meats and foods, and

• disregard authorities who condemned the wearing of corsets.

While urging the cooperation of the public in health matters, the
State Board of Health was poorly financed and beset by opposition.
During its first quadrennial term (1889-1893), receipts were
$114,683, Salaries and operating expenses did not exceed $60,000

FLORIDA HEALTH NOTES

281

Public Health officials
frowned upon women's
fashions, especially the
corset, on instrument of
torture which produced
the fashionable wasp-like
figure.

for the four year period. Most of the balance of the funds went
for a steam and vapor disinfecting plant, a quarantine station of
"modern design" and a quarantine patrol boat.

Dr. Porter expressed the hope that the Legislature, "should it
give a careful examination of the accounts of the Board of Health,"

282

FLORIDA HEALTH NOTES

would find that the funds were "carefully managed and expended
with due regard to economy and efficiency." The questions, "How
much will it cost?" and "Can the state afford it?" were asked more
often than "Without this protection (of the State Board of Health),
how many lives may be taken by an epidemic or what damage
would the commercial interest experience?"

The State Board of Health was always consistent in its acts
and teaching. It tried to advise and suggest only those measures
in hygiene and sanitation which could be practicably applied by
the people of Florida.

In an effort to tell what the health picture was in Florida, each
issue of Health Notes carried reports from the counties. The re-
port for March 1896 stated "exceptionally good health," although
influenza or "La Grippe" prevailed to some slight extent in cer-
tain counties, while mumps, measles and pneumonia were also
existent "though not so general as theretofore "reported." A case
of smallpox was reported in Escambia County in March 1896 but
the disease did not spread.

For some years after the yellow fever epidemic of 1888, people
were somewhat timorous about remaining in certain parts of the
state through the summer months. But by the end of the 1890s,
this feeling was overcome and Health Notes declared that "Florida
summer is to the favored resident of the state a thing of beauty
and joy forever, while its ever-refreshing breezes so tempering
the heat of the sun while its healthfulness is an established fact."

An Interest in Education

Educational efforts were made by the State Board of Health
to interest Floridians in their own health, the health of their
neighbors and the community in general. They were told that they
owed themselves good health and to "live so that health may not
be impaired, strength wasted and life prematurely shortened."

As good citizens they were asked to guard jealously the health
of their neighbors by not permitting cesspools or privy vaults
under a neighbor's bedroom window to poison the atmosphere

FLORIDA HEALTH NOTES • 283

i

and concealing a case of measles or whooping cough, which could
cause grief, to say nothing of expense or anxiety, to neighbors.

The State Board of Health and physicians continually carried
on a campaign to educate the people in such sanitary matters as:

causes and sources of sickness,
importance of clean food and pure water,
danger of contamination of wells,
value of drainage,
importance of dry and clean cellars,
value of ventilation, sunshine and fresh air,
ways in which disease may be conveyed from one person to
another,

importance of perfect disinfection and the necessity of know-
ing the proper way to accomplish this, and
necessity of isolation and quarantine.

|

Communicable Diseases

i

The legislative act that set up the State Board of Health

repeatedly mentioned "yellow fever, smallpox and cholera," Other

diseases and sanitation were given less priority and, perhaps

I because of this, Health Notes continually urged the county boards

of health to report incidents of all communicable diseases, in-

1 eluding such illnesses as diphtheria, scarlet fever and measles. De-

spite this, however, many county boards kept failing to make
complete reports.

Campaign Against Rumors

Because of the lack of rapid communications, a state law was
passed against the spreading of false or malicious rumors or reports
concerning the existence of any infectious or contagious disease.
Punishment consisted of up to six months in prison or fines not
exceeding $1000.

284 • FLORIDA HEALTH NOTES

Even as late as the 1890s, people thought of epidemics as
"visitation of Providence" but "Providence" usually visited the
unclean with pestilence much oftener than it did the scrupulously
clean. People who tolerated dangerous nuisances, such as cess-
pools, unsanitary cellars — containing decaying vegetables and
fruits — and stables too near the house, too often had to pay the
penalty with typhoid fever, diphtheria and other filth diseases.
Fevers were often prevalent in country districts which should have
been healthy.

Prior to the formation of the State Board of Health, yellow
fever, smallpox and cholera were rampant in Florida, but by the
end of the 1890s these diseases were nearly under control through
quarantine, disinfection, sterilization, smallpox vaccination and
improved sanitation.

The Yellow Jack

Yellow fever (also called Yellow Jack) was constantly feared
in Florida during the 1890s. Havana, Cuba, just across the Florida
Straits, had 470 cases with 111 deaths from the disease in the one
month of July 1893. Due to ships arriving in Florida ports from
Havana, the State Board of Health maintained surveillance of all
foreign shipping by inspection stations at Key West, Punta Rassa,
Boca Grande Pass (Charlotte Harbor), Anclote Keys, Cedar Key
and Apalachicola ; quarantine stations were located at Mullet Key
(Tampa Bay) and Santa Rosa Island (Pensacola Bay).

At these stations, personal effects of crews and passengers,
such as baggage, clothing, eating utensils and letters, were in-
spected, sterilized, fumigated and disinfected in the search for
fo miles which were thought to carry communicable diseases. Pre-
vention of the introduction and spread of fomites into any port
of the state was one of the principles which the State Board of
Health strenuously enforced.

In one particular case recorded in Health Notes, the State
Health Officer stood up to the Federal Government over the en-
forcing of the state's quarantine laws. In 1896 the Spanish cruiser,
Infanta Isabel, coming from Havana, sought to enter the Port of

FLORIDA HEALTH NOTES • 285

Key West but was forbidden to do so without first going through
inspection, disinfection and sterilization of the personal effects of
the officers and crew. The cruiser refused, withdrew and sailed
directly to Tampa where late in the afternoon she passed the quar-
antine station without stopping.

The next morning the quarantine launch sighted and boarded
the cruiser and forced her to return to the quarantine station for
inspection. Because the cruiser had had many cases of yellow
fever aboard during the previous year and no disinfection for
fomites was practiced, the Infanta Isabel was placed in quarantine
and subjected to the same treatment as any vessel from a foreign
infected port. The Federal Government asked for the release of
the cruiser but Dr. Porter insisted upon enforcing the state's laws.

It was a matter of concern to the physicians of Florida, and
particularly to those residing on the coast, that they be able to
speedily recognize a case of yellow fever in its mild form as each
summer season brought anxiety because of the nearness of the
home of yellow fever — Cuba.

"How can one tell a mild case of yellow fever in its incipiency?"
was frequently asked, but in the August 1893 issue of Health
Notes the State Board of Health acknowledged that it had no
satisfactory answer.

When yellow fever did occur, steps were taken to isolate and
guard the premises where a death occurred. The State Health
Officer took official charge of the investigations and autopsies
which were performed. House-to-house investigations were made
to trace every rumored suggestion as to how yellow fever might
have reached the area.

Although epidemics of yellow fever raged in almost all of the
countries south of Florida during the 1890s, few cases developed
in the state. This was believed due to the careful inspection of
all vessels and rigid enforcement of the quarantine regulations.
Despite the precautions the last epidemic in the state occurred in
Pensacola in 1905 with 572 officially-reported cases and 82 deaths.
The last case was Gilbert A. Hovey of 821 North 7th Avenue,
who was stricken November 26, 1905, and died on December 4.

286 • FLORIDA HEALTH NOTES

HKLMBOT^yn i^litix* ErxTTtA-crr bi*chu.

H

I
A

SB

Seen gathering Buchu Leaves at tne oape qi uood Hope, lor

B T. BBLMBOLD, Dru 5 gi*t,

Wew Tor k .

Advertisements, including medicinal, took the exotic approach during the
1890s.

Smallpox

Despite the fact that smallpox, a disease which had swept
away one-sixth of the human race over the centuries, was being-
brought under control by vaccination, many people in Florida in
the 1890s resisted compulsory vaccination.

In 1896 an epidemic of smallpox, involving 42 cases and eight
deaths, threatened Key West because of the length of time the
disease had existed in the city before it was discovered by the
State Health Officer and because of opposition by the city govern-
ment to advice and assistance offered by the State Board of
Health.

However, an epidemic was averted when people with the disease
were isolated (despite near riots) ; houses where cases occurred

FLORIDA HEALTH NOTES

287

Deadly communicable diseases were a major concern of the State Board
of Health during the 1890s and treatment was often uncertain.

<

were disinfected ; and vaccination and revaccination of people were
carried out in areas where cases were located. When the first
cases were discovered, 12,000 out of the city's population of
18,000 had not been vaccinated. During the epidemic, 8000 of
those unvaecinated persons received smallpox vaccine.

In 1898, Health Notes stated that compulsory vaccination may
have appeared to be an infringement upon the personal rights of
the individual but the State Board of Health took the position that
when the individual's relations to society were such that he be-
came dangerous to the life and health of others, he should be
considered a nuisance and legally treated as such. A law which

288

FLORIDA HEALTH NOTES

compelled vaccination reached beyond the personal question and
affected the interests of the community for every un vaccinated
person contributed to the material that increased great epidemics.
No city with a large unvaccinated population was considered safe
from the ravages of smallpox.

During the decade a number of persons were ordered by the
courts to be vaccinated and these were reported in Health Notes.

Consumption or Tuberculosis

During the 1890s, Florida became a Mecca for many people
who suffered from consumption. As the mild climate of the state
became more widely heralded, more and more persons suffering
from various diseases of the respiratory system came to Florida
for the season. In November 1893, the State Board of Health
advocated :

notification and registration by authorities of all infectious
cases of tuberculosis who had arrived in Florida,

thorough disinfection of all houses in which tuberculosis had
occurred and the recording- of such action in an open record,

establishment of special hospitals for the curing of tuber-
culosis, and

government inspection of dairies and slaughterhouses and the
extermination of tuberculosis among dairy cattle.

The State Board of Health cautioned the readers of Health
Notes against the consumptive persons and urged that they not
be allowed to mingle with guests at resorts, that separate apart-
ments should be maintained for these people, and that they have
closely supervised hygiene and sanitation practices.

The State Board of Health said that invalids with chest and
throat diseases made three errors in coming to Florida. They did
not come to the state early enough in their illness to receive the
full benefit of the climate. They returned North in the early spring
before climate conditions had become mild or temperate at home.
They persisted in living in overheated and closed rooms rather than
in the outdoors which was more beneficial.

FLORIDA HEALTH NOTES • 289

Typhoid Fever

Since typhoid fever was traced to impure drinking water and
the lack of proper sewage disposal, the prevalence of typhoid fever
was no longer considered a misfortune calling for sympathy but an
indictment of the "popular intelligence" as behind the times. The
months of August, September and October were periods of in-
creasing and extraordinary dangers from typhoid fever. Because
the germ was known to be "in the discharge from the bowels,
in the urine, in the spleen and probably prevailed in the entire
body" of a person having typhoid fever, many issues of Health
Notes during the decade urged the boiling of all drinking water
not known to be above suspicion. It stated in April 1895, that all
efforts should be united to obtain pure water supplies and, since
the cause and remedy were known, it was the duty of interested
persons and governments to procure such help from sanitary
engineers and others that would give the desired results — the
control of the disease.

Other Communicable Diseases

Malaria, which means "bad air" was reported by Health Notes
to have been "caused by an organism or parasite, not a bacillus,
which gets into the blood and takes all the life out of the little
corpuscles." The germ was believed to live and thrive in low
marshy regions where there was stagnant water and most prevalent
in the autumn. When frost appeared the germ was destroyed.
Unlike most diseases, people who had malaria were more apt to
have it again.

There was continual vigilance against cholera. In 1892, Health
Notes warned of a possible epidemic of this disease because
thousands of immigrants from the infected areas of Russia were
allowed by the Federal Government to enter the United States.

Another issue of Health Notes included an article by a
physician who described a person dying of rabies. He said that
death occurred 48 hours after the first symptoms appeared and

290 • FLORIDA HEALTH NOTES

there was "no attempt to harm attendants or attempts to mimic
the bark of a dog or the cry of a cat."

Health Notes also stated in April 1896 that there was a
prevalent but erroneous idea that measles was not dangerous and
little effort was made to restrict its spread in some localities.
However, statistics show the "magnitude of the dangers resulting
from this opinion and neglect" and the benefits resulting from the
same preventive measures used against other communicable dis-
eases.

Syphilis Contracted from Cigars?

"Dr. S. W. Gottheil, in a letter to the NEW YORK MEDICAL
JOURNAL, published March 19, 1892, points out the dangers of
syphilis being communicated by cigars. He gives the history of two
cases (girls) of secondary syphilis, one of whom was suffering from
a chancre an the lip, which she had acquired by drinking out of a
cup used by the other, who had numerous mucous patches in the
mouth. The girls were cigar finishers, and took the cigars from
the machine, biting off the ends and using their saliva for finishing
the tips. Neither of them would believe that the disease was con-
tagious and both of them continued to work as before, 'because it
took too long to use the knife and brush.' "

FLORIDA HEALTH NOTES, March 1893

• _*___

Dengue fever was quite prevalent in the peninsular portion
of the state for many years. It was said to resemble seasickness
in that it caused aching bones and muscles and a rash but was
similar in some of its symptoms to yellow fever. The latter was
often mistaken for dengue. During one epidemic there were 500
to 600 cases reported in Kissimmee and in 1894, 97 of 115 men
at a military barracks in Key West were attacked by the disease.

During the summer of 1894 the Texas State Board of Health
closed Galveston Harbor to passengers from Key West because
if dengue fever which Texas authorities felt was a quarantinable

FLORIDA HEALTH NOTES

291

disease. Dr. Porter protested the action but the quarantine pre-
vailed for the year.

The Fight for Cleanliness

One of the early editions of Health Notes stated that the "sani-
tarian attacks the mortality rate when he feels it too high and
that it may be lowered by his personal efforts." Throughout the
1890s the magazine advocated proper sanitation and noted that
"formerly appeals to Deity to ward off the scourge was the manner
in which diseases were expected to cease but only when London
was thoroughly cleaned did the great plague come to an end."

Municipalities were urged to cut weeds, prevent the dumping
of garbage and trash in vacant lots and inspeet alleys and back-
yards frequently. Householders were cautioned against cesspools
under kitchen windows ; sanitarians were charged with checking
privies, making examples of those who persisted in violating health
ordinances, carrying out monthly house-to-house inspections to
ascertain the number of sick and, if possible, the cause of the
illness and admonishing against the use of well water, particularly
wells near barnyards and privies.

In August 1898, notice was taken of city ordinances which
prohibited the sweeping of streets and sidewalks, except at pre-
scribed times and only after sprinkling sufficiently to allay the
dust . . . this would do much "to prevent dissemination of disease
germs of tuberculosis and diphtheria." In an earlier issue, Health
Notes stated that "it is a fact that clean and well-kept streets
caused a marked reduction in the death rate of large cities, par-
ticularly as regard to malaria and pulmonary ailments."

Outside the cities, sanitation in the 1890s was sadly neglected.
In many of the smaller towns, methods for the deposit of refuse
and garbage were almost as crude as when the country was first
settled. The drainage was bad ; the drinking water was in constant
danger of pollution; if a case of typhoid fever appeared, an epi-
demic was very likely to follow. Safe sanitation practices were
frequently neglected, such as:

292 • FLORIDA HEALTH NOTES

r ''-' r # tts$l>

Disease and poor sanitary practices were often prevalent in rural Florida
in the 1890s.

wells for drinking 1 water generally located convenient to the
house, irrespective of the position of the privy vault, pigsty or
stable ;

privy vaults ordinarily not made water tight and drainfields
haphazardly located; and

pigsties usually located not far from the abode of man and
not kept in a clean condition.

Advice was given on how to fight microbes. Water and fresh
air were considered the greatest sanitary agents. The germs of
many of the worst diseases were conveyed in drinking water and
Floridians were urged to use pure water only. Health Notes added
in July 1895 that water could be "rendered perfectly pure and
safe by boiling and filtering ... it is dangerous to drink water
which has stood overnight in a closed room, especially in a room
occupied by a person or living animal."

FLORIDA HEALTH NOTES

293

Fresh air could be obtained without money and "nothing which
will kill disease germs as quickly as the application of fresh air
and the rays of the sun." Floridians were urged to use disin-
fectants freely and fumigation was said to reach every corner
of a room where germs were apt to lurk. The cheapest material
for fumigation was sulphur.

School, Child and Maternal Health

Health Notes took notice in several issues of school buildings,
playgrounds and classroom hygiene.

Ventilating, heating and lighting in schools and the seating of
students were of concern to the State Board of Health. Ventila-
tion depended upon the number of occupants, dimensions of the
room, height of eeilings and number of external openings. Since
the number of days in winter when artificial heat was needed was
small, compared with the days when fires were not required, the

A Step To word Proper SanitoHon

The July 1895 issue of FLORIDA HEALTH NOTES stared that
a six-man jury in the thriving community of West Palm Beach in
Dade County recommended the passage of sanitary ordinances and
the placing of boxes and barrels on the streets and highways for
the reception of refuse. The State Board of Health commended
West Palm Beach for the action and recommended the practice to
other cities of Florida.

subject of warming of schoolrooms was "only referred to." Light-
ing came from windows so these were placed so that the strongest
light came from the left side of the students.

The State Board of Health called for school boards of the state
to see that all schoolbuildings had spacious grounds to give "chil-
dren ample opportunity for healthful exercise." These were to be

294

FLORIDA HEALTH NOTES

filled with "simple, gymnastic appliances which will induce pre-
cise movements and occurring of attention to details of exer-
cise . . ."

Schools were urged to provide an abundance of pure water.
Schoolrooms were to be cleaned, disinfected frequently and well
aired during recreation periods and at night,

A scholar complaining of fever was to be sent home im-
mediately and it was recommended that all other children of the
home be kept out of school. Personal belongings of the students
were to be removed and disinfected or destroyed according to
the nature and severity of the disease.

Health Notes stated in July 1894 that "special attention should
be directed toward (child) bearing women" but the State Board
of Health had no such program as it has today. The agency con-
templated a crusade of education for midwives and made an ap-
peal to readers of Health Notes for papers and short articles for
their education. The indiscriminate practice of midwifery in the
state without legal or other restrictions was seen by the State
Board of Health as jeopardizing the lives of many helpless women
and children.

Vital statistics revealed more deaths under one year than be-
tween the ages of one to 25 and disclosed "very defective sanita-
tion and hygiene as applied to those under one year."

The Beginning of Vital Statistics

The State Board of Health continually tried to bring about
an accurate and complete registration of vital statistics and urged
medical practitioners to report births and deaths as soon as pos-
sible.

FLORIDA HEALTH NOTES • 295

Many nonwhite births and deaths were not reported and physi-
cians, nurses and midwives were urged to report deaths and births
in their community whether or not they attended the event. Those
reporting such information to the State Board of Health were
asked to answer all questions "but don't fail to report if you can't."
They were asked to pay attention to nomenclature, write causes
of death plainly, report stillbirths on death cards, and fill out ap-
parently minor details.

In September 1898, Health Notes stated that physicians should
endeavor to specify the cause of death as definitely and correctly
as possible. It noted that it was not unusual to find a physician's
certificate naming the cause of death as "paralysis, paraplegia,
fits, convulsion, dropsy, etc., which were considered merely sec-
ondary or consecutive causes . . . simply symptoms only or results
of some organ lesion or pathological disrangement."

!

HEALTH NOTES in November 1894 remarked that physicians
in one of the more populous counties were loathe to contribute to the j
successful workings of the State Board of Health. They objected to j
the blanks used in reporting births because of the number of ques
tions they termed "unnecessary."

Nutrition in the 1890s

Health Notes remarked that Americans were noted for the
enormous quantity of food they consumed and "it is a fact that
most of our people eat just double as much as they should . . .
They could do better and more work on half the food . . . Fully
five-sixths of the diseases and sickness in our country is brought
on by overeating and drinking."

In 1896, the publication noted a nutritious way to "good health
and vigor:"

296 • FLORIDA HEALTH NOTES

Florida's subtropical climate and healthful recreational facilities were
mentioned often in early issues of HEALTH NOTES.

"Let every summer dweller in Florida of bilious temperament
provide himself a stock of good lemons and every morning; and at
least half hour before breakfast, take the juice of half or whole one
in a pint of water without sugar ... do not neglect it for a single
morning until you begin to feel the reinvigorating effects of the
approaching autumn frost and we will with reasonably prudent
living, in other respects, almost guarantee you good health and
vigor all summer."

Public Health in Retrospect

This has been a look at public health in the 1890s and some of
the ideas are strange to us today. Seventy-five years ago com-

FLORIDA HEALTH NOTES

297

m unicable diseases were a major threat to the people of Florida
and aside from quarantine and fumigation there was little to be
done. In the years since that time communicable diseases have
ceased to be such a problem — but there are other things, such as
air and water pollution, which are considered just as great health
hazards.

Today the State Board of Health is still concerned with sewage
disposal, plus industrial waste, which the Board did not worry
about in the 1890s. It is concerned with adult health and chronic
diseases, which were once considered as part of every elderly
person's inheritance. Hospitals, nursing homes (which were not
even heard of in those days) and Medicare are playing a larger
part in the total health picture. Many programs never dreamed
of by Dr. Porter and the State Board of Health in the 1890s, such
as radiological health, are standard programs in today's public
health picture.

But some of the problems faced by Dr. Porter still exist. The
population has increased from 391,442 in 1890 to 5,940,000 in
1967. During the first four years of operation, the State Board
of Health's receipts were approximately $114,000. In 1966, the
receipts from all sources. were over $41,000,000. But, today, due to
the expanding population, financing is still a major problem.
Where Dr. Porter had only a small staff, the State Board of
Health family numbers several thousand workers. But still there
is a shortage of professional people to carry on the programs.

One of the major items that Health Notes sought in its first
issue is still a factor in the work of the State Board of Health
today — that is the cooperation of the people of Florida for better
health.

HLn»tr»tiona: Cover — Courtesy of Florida Publishing Co.; pases 278, 282. 287 mid 293 — Blay.
John S. After the Civil War. Crowell Co., New York, 1960; pages 188 and 297 — Downey,
Fairfax Portrait of in Era as Drawn by C. D. Gibson. Scribner's Sons. New York, 1936.

298 • FLORIDA HEALTH NOTES

FLORIDA

NOTES

OLUME59 — NO. 8

A JGUST

1967

MOBILE HOME LIVING

vv— -■•: v i,

municable diseases were a major threat to the people of Florida
and aside from quarantine and fumigation there was little to be
done. In the years since that time communicable diseases have
ceased to be such a problem — but there are other things, such as
air :ind water iwllution, which are considered just as great health
hazards.

Today the State Board of Health is still concerned with sewage
disposal, plus industrial waste, which the Board did not worry
about in the 1890s. It is concerned with adult health and chronic
diseases, which were once considered as part of every elderly
person's inheritance. Hospitals, nursing homes (which were not
even heard of in those days) and Medicare are playing a larger
part in the total health picture. Many programs never dreamed
of by Dr. Porter and the State Board of Health in the 1890s, such
as radiological health, are standard programs in today's public
health picture.

But some of the problems faced by Dr. Porter still exist. The
population has increased from 391,442 in 1890 to 5,940,000 in
1967. During the first four years of operation, the State Board
of Health's receipts were approximately $114,000. In 1966, the
receipts from all sources were over $41,000,000. But. today, due to
the expanding population, financing is still a major problem.
Where Dr. Porter had only a small staff, the State Board of
Health family numbers several thousand workers. But still there
is a shortage of professional people to carry on the programs.

One of the major items that Health Notes sought in its first
issue is still a factor in the work of the State Board of Health
today — that is the cooperation of the people of Florida for better
health.

innutritions : Cover — Courtesy of Kloridn Publishing? Co. ; pun 278, Wi, 2S7 and 293 — Blay.
John S, After the Civil War. Crowd! Co., New York. 1910; pair™ 2SS nnd 297— l'«w n<-y.
Fairfax Portrait of an Era u Drawn by C. D. Gibson. Seribnpr"* Sonn, Maw York, IB3G.

298 • FLORIDA HEALTH NOTES

FLORIDA

HEALTH
NOTES

\UUME 59— NO. 8

A JGUST

1967

MOBILE HOME LIVING

(Cover photo) A new
trailer, without its
awning, cabana, car-
port and skirtings, sits
in o trailer space of a
mobile home park
waiting to be oc-
cupied. Both single
and double trailers are
papular with Florida's
residents and tourists.

• •"

The double mobile
home has the same
conveniences and is
nearly as large as a
permanent house. The
24-foot living room
(abovel and dining
area (right) occupy
part of the two con-
nected trailers.

MOBILE

HOME

LIVING

Mr. and Mrs. Brown, a retired couple, spend the cooler months
of the year living in a mobile home located in a well-kept mobile
home park in a Florida city. The rest of the year they reside in
their home in a northern city.

Mr. and Mrs. Smith, who are semi-retired, reside in a mobile
home park in another Florida city. They prefer this type of living
because of the low cost maintenance of their residence and the
social life of the park.

Mr. and Mrs. Young and their three children are living tem-
porarily in a mobile home park. They are renting their trailer
until Mr. Young can find work and then the family will move into
a permanent home.

Sergeant and Mrs. Jones, a military family, live in a trailer next
to the Youngs but they own their mobile home. Sgt. Jones has re-
ceived orders to a military base on the West Coast and he will move
his family — trailer and all.

Another retired couple, Mr. and Mrs. Wanderers, are touring the
United States and using a travel trailer as their home. Because
their trailer does not have all of the facilities of a mobile home

FLORIDA HEALTH NOTES • 303

-/

(Cover photo) A new
trailer, without its
owning, cabana, car-
port and skirtings, sits
in a trailer space of a
mobile home park
waiting to be oc-
cupied. Both single
and double trailers are
popular with Florida's
residents and tourists.

1 w\

l(

!

W • ;»

^^H

^ *^M

? '*

1

I — ■■■-

:^¥*

^■iW^V

T

t

The double mobile
home has the same
conveniences and is
nearly as large * a
permanent house. The
24-foot living room
(above' and dining
area I right) occupy
part of the two con-
nected trailers.

J

MOBILE

HOME

LIVING

Mr. and Mrs. Brown, a retired couple, spend the cooler months
of the year living in a mobile home located in a well-kept mobile
home park in a Florida city. The rest of the year they reside in
their home in a northern city.

Mr. and Mrs. Smith, who are semi-retired, reside in a mobile
home park in another Florida city. They prefer this type of living:
because of the low cost maintenance of their residence and the
social life of the park.

Mr. and Mrs. Young and their three children are living tem-
porarily in a mobile home park. They are renting their trailer
until Mr. Young can find work and then the family will move into
a permanent home.

Sergeant and Mrs. Jones, a military family, live in a trailer next
to the Youngs but they own their mobile home. Sgt. Jones has re-
ceived orders to a military base on the West Coast and he will move
his family — trailer and all.

Another retired couple, Mr. and Mrs. Wanderers, are touring the
United States and using a travel trailer as their home. Because
their trailer does not have all of the faedities of a mobile home

FLORIDA HEALTH NOTES

303

trailer, they must park their trailer where bathroom, shower and
laundry facilities are provided.

The one thing that made mobile home living possible was the
addition of a complete bathroom in the trailer which made the
central bath house of the old-style trailer courts obsolete. The
mobile home, with the bathroom, is called an "independent" trailer
and it is attached to a central sewerage system or septic tank. The
trailer park may have its own sewage treatment plant or its system
may be attached to a public sewerage system. Over 105,700 of the
trailer spaces in Florida's 2523 mobile home parks are designated
for independent trailers.

The dependent trailer does not have its own bathroom and its
occupants must use a central bath house, with toilets and showers,
which may serve the whole park. A few trailer parks have built
small bath houses to serve a block of four trailers in the immediate
vicinity. Only 4628 trailer spaces in Florida's parks are for de-
pendent trailers.

li

The State Board of Health and County Health Departments are
interested in trailers as "homes" because of the environmental
health of the residents, the tendency to crowd trailers together, the
problem of pure water, and sewage and garbage disposal. Because
of these health factors, they favor the use of independent trailers
connected to central sewerage systems.

In this issue of Florida Health Notes we will give you some of
the facts about mobile homes, tell you why people like this type of

FLORIDA HEALTH NOTES

Published monthly by the Ftorido State Board at Health, Wilson T. Sawder, M.D., M.P.H.,
State Health Officer, Publication office. Box 210, Jacksonville, Florida 32201, Second class
postage paid at Jacksonville. Florida, This publication is tor individuals and institutions with
on interest in the state's health programs. Permission is given to quote any story providing
credit is given to the Florida State Board of Health. Editor: Robert A Schoonover, ma.
Division of Health Education.

VOLUME 59— NO. S

AUGUST 1967

304

FLORIDA HEALTH NOTES

The informal way of life in Florida's mobile home parks revolves around the
swimming pool and recreation building.

life, and present some of the problems County Health Departments
and the State Board of Health face with mobile home parks.

Trailers and the Sanitary Code

The trailer "tin cans" of the 1920s and 1930s were little more
than just places to sleep and did not have any of the comforts of a
"home." In the late 1930s, trailer camps sprung up because there

FLORIDA HEALTH NOTES

305

trailer, they must park their trailer where bathroom, shower and
laundry facilities are provided.

The one thing that made mobile home living possible was the
addition of a complete bathroom in the trailer which made the
central bath house of the old-style trailer courts obsolete. The
mobile home, with the bathroom, is called an "independent" trailer
and it is attached to a central sewerage system or septic tank. The
trailer park may have its own sewage treatment plant or its system
may be attached to a public sewerage system. Over 105,700 of the
trailer spaces in Florida's 2523 mobile home parks are designated
for independent trailers.

The dependent trailer does not have its own bathroom and its
occupants must use a central bath house, with toilets and showers,
which may serve the whole park. A few trailer parks have built
small bath houses to serve a block of four trailers in the immediate
vicinity. Only 4628 trailer spaces in Florida's parks are for de-
pendent trailers.

The State Board of Health and County Health Departments are
interested in trailers as "homes" because of the environmental
health of the residents, the tendency to crowd trailers together, the
problem of pure water, and sewage and garbage disposal. Because
of these health factors, they favor the use of independent trailers
connected to central sewerage systems.

In this issue of Florida Health Notes we will give you some of
the facts about mobile homes, tell you why people like this type of

FLORIDA HEALTH NOTES

Published monthly by the Florida Store Board of Heolfh, Wilson T. Sawder, M.D., M.P.H ,
State Health Officer. Publication office Box 210. Jacksonville. Florida 32201. Second clou
postage paid at Jacksonville. Florida. This publication is for individuals and institutions with
on interest in the state s health programs. Permission is given to quote any slory providing
credit is given to the Florida Slate Board of Health. Editor; Robert A. Schoonover, MA.
Division of Health Education.

VOLUME 59— NO, 8

AUGUST 1MT

304

FLORIDA HEALTH NOTES

The informal way of life in Florida's mobile home parks revolves around the
swimming pool and recreation building.

life, and present some of the problems County Health Departments
and the State Board of Health face with mobile home parks.

Trailers and the Sanitary Code

The trailer "tin cans" of the 1920s and 1930s were littk more
than just places to sleep and did not have any of the comforts of a
"home." In the late 1930s, trailer camps sprung up because there

FLORIDA HEALTH NOTES

305

was not enough housing to accommodate the workers drawn to
Florida by the construction of military bases. Service personnel
who moved frequently found trailers convenient. Tourism was
another factor why trailer camps developed in large numbers.

The camps were hardly more than vacant lots where trailers
were parked for a couple of dollars a month. Trailers were jammed
together helter-skelter and only a few camp operators built facili-
ties for laundries, showers and toilets. There was a good reason
why all operators did not build such facilities — they were not re-
quired to do so.

The State Board of Health and County Health Departments saw
the congestion of people in these crowded camps. The 1939 Legis-
lature passed a law which required trailer camps to meet minimum
standards of the Florida Sanitary Code and stipulated that the
State Board of Health was to issue trailer camp permits. The State

This mobile home is built of a double trailer (right) and a single trailer
(beyond the screened private swimming pool).

306

FLORIDA HEALTH NOTES

A unique use of a mobile home is rhis one on pilings with a carport beneath.

Board of Health and County Health Departments were hard press-
ed to inspect the camps because of the shortage of personnel.

Since that time the Sanitary Code has been updated. Changes
were made such as enlarging the space for trailers from about 900
square feet to the present 2400 square feet (to acommodate the
bigger trailers), widening the roads in the trailer parks, removing
the requirement for the central bath house in parks which are only
for trailers with their own bathrooms, and adding the provision for
central sewerage systems.

Today the County Health Departments have the inspection of
trailer parks as a regular part of their environmental health pro-
grams. In some Health Departments the sanitarian, who is in
charge of a district, inspects the parks in his area; other Health
Departments have specialists who are responsible for all mobile
home parks in the county.

FLORIDA HEALTH NOTES

307

was not enough housing to accommodate the workers drawn to
Florida by the construction of military bases. Service personnel
who moved frequently found trailers convenient. Tourism whs
another factor why trailer camps developed in large numbers.

The camps were hardly more than vacant lots where trailers
were parked for a couple of dollars a month. Trailers were jammed
together helter-skelter and only a few camp operators built facili-
ties for laundries, showers and toilets. There was a good reason
why all o|)erators did not build such facilities — they were not re-
quired to do so.

The State Board of Health and County Health Departments saw
the congestion of people in these crowded camps. The 1939 Legis-
lature passed a law which required trailer camps to meet minimum
standards of the Florida Sanitary Code and stipulated that the
State Board of Health was to issue trailer camp permits. The State

This mobile home is built of a double trailer I right' and a single frailer
'beyond the screened private swimming pool I.

306

FLORIDA HEALTH NOTES

A unique use of a mobile home is this one on pilings with o carport beneath.

Board of Health and County Health Departments were hard press-
ed to inspect the camps because of the shortage of personnel.

Since that time the Sanitary Code has been updated. Changes
were made such as enlarging the space for trailers from about 900
square feet to the present 2400 square feet (to acommodate the
bigger trailers), widening the roads in the trailer parks, removing
the requirement for the central bath house in parks which are only
for trailers with their own bathrooms, and adding the provision for
central sewerage systems.

Today the County Health Departments have the inspection of
trailer parks as a regular part of their environmental health pro-
grams. In some Health Departments the sanitarian, who is in
charge of a district, inspects the parks in his area; other Health
Departments have specialists who are responsible for all mobile
home parks in the county.

FLORIDA HEALTH NOTES

307

Why Do People Prefer Mobile Home Living

Hundreds of thousands of Floridians live in trailers located in
mobile home parks. These parks are no longer known as "trailer
courts" and to the aficionado (devotee) of this way of life "trailer
courts" are fighting words.

1

There is more camaraderie (loyalty and good spirit) in a mobile
home park than in the normal community. The people live under
similar circumstances and such problems as stray dogs or sanitary
problems affect the park "community" as a whole.

The residents of the park frequently share recreational costs.
Some parks have elaborate recreational centers with game rooms,
kitchens, dining rooms, swimming pools and yacht basins, which
give the park a country club atmosphere. Such activities as splash
parties, shuffleboard and bridge tournaments, card parties, volun-
teer work, dancing, potluck suppers, ehapel services, etc., are com-
mon in most mobile home trailer parks. Some park communities
have residents' associations which charge small dues to cover the
costs of the social activities.

Facts About Mobile Homes

The first trailers in which people lived were small units about
eight feet wide and 20 feet long. Mobile homes today are 12 feet or
more in width and up to 70 feet in length. The huge double "jobs,"
consisting of two trailers side by side, are as elaborate and nearly
as large as small houses. When they are set up in a mobile home
park, it is difficult to tell them from a house and many of them are
not readily movable. Most trailers stay in the park during the
whole year but even with the attached screened cabanas and patios
they can be moved. Some trailers are put on permanent founda-
tions and enlarged with additional rooms. The large movable trail-

308

FLORIDA HEALTH NOTES

Many of the newer mobile home parks have elaborate recreation buildings
which are used for card parties, bazaars, dances, potluck suppers, etc.

ers, themselves, are more like normal, permanent houses with two
or three bedrooms, and larger kitchens, dining- and living' rooms.

There are less maintenance problems with a mobile home. The
owner only has to wash his trailer down with a hose occasionally
and paint the top of the trailer every two years. There is less lawn

FLORIDA HEALTH NOTES

309

Why Do People Prefer Mobile Home Living

Hundreds of thousands of Floridians live in trailers located in
mobile home parks. These parks are no longer known as "trailer
courts" and to the aficionado (devotee) of this way of life "trailer
courts" are fighting words.

There is more camaraderie (loyalty and good spirit) in a mobile
home park than in the normal community. The people live under
similar circumstances and such problems as stray dogs or sanitary
problems affect the park "community" as a whole.

The residents of the park frequently share recreational costs.
Some parks have elaborate recreational centers with game rooms,
kitchens, dining rooms, swimming pools and yacht basins, which
give the park a country club atmosphere. Such activities as splash
parties, snuff leboard and bridge tournaments, card parties, volun-
teer work, dancing, pot luck suppers, chapel services, etc., are com-
mon in most mobile home trailer parks. Some park communities
have residents' associations which charge small dues to cover the
costs of the social activities.

Facts About Mobile Homes

The first trailers in which people lived were small units about
eight feet wide and 20 feet long. Mobile homes today are 12 feet or
more in width and up to 70 feet in length. The huge double "jobs,"
consisting of two trailers side by side, are as elaborate and nearly
as targe as small houses. When they are set up in a mobile home
park, it is difficult to tell them from a house and many of them are
not readily movable. Most trailers stay in the park during the
whole year but even with the attached screened cabanas and patios
they can be moved. Some trailers are put on permanent founda-
tions and enlarged with additional rooms. The large movable trail-

308 • FLORIDA HEALTH NOTES

Many of the newer mobile home porks have elaborate recreation buildings
which are used for card parties, bazaars, dances, potluck suppers, etc.

ers, themselves, are moi-e like normal, permanent houses with two
or three bedrooms, and larger kitchens, dining and living rooms.

There are less maintenance problems with a mobile home. The
owner only has to wash his trailer down with a hose occasionally
and paint the top of the trailer every two years. There is less lawn

FLORIDA HEALTH NOTES

309

I

II .

.11

:: ,
■

fti"

r

Jp

to

■

1

Travel Trailers and Campers

More and more Florida and non -Florida families are taking vaca-
tions in the state with travel trailers and campers just large enough
for sleeping and/or cooking. People who travel in these need showers
and toilet facilities but few mobile home parks are equipped to provide
these services. Some parks are making space and facilities available
for travel trailers; however, the demand is seasonal and during the
cooler months these parks are crowded.

Twenty-four state parks in Florida provide a limited number of
spaces for tent and trailer camping. On weekends and holidays these
facilities are jammed beyond the planned number of campers. Because
the parks operate on a first-come-first-served basis, many people are
turned away or allowed to camp along the roads of the park.

to care for and frequently the mobile home park does this for the
residents.

The cost of a mobile home ranges upward from $3500; some
with screened rooms and private swimming pools may cost as much
as $25,000 — or more. Furniture may or may not come with the
trailers from the mobile home factory. These factories generally
do not manufacture furniture. In modern mobile home parks, the
owners may set up models similar to those in a housing subdivision
and sell from these models. Some park operators, as a sideline
business, decorate the trailers to suit the tastes of the buyer. Other
mobile home parks are connected to trailer sales lots and the
trailers are merely moved into the parks. Sometimes the trailers
are hauled a short distance to another mobile home park the buyer
prefers or the trailers may be moved many hundreds of miles. The
cost of moving a trailer may run as high as $300 or more- — depend-
ing upon the distance and such attachments as cabanas, awnings
and carports which must be removed and then re-attached.

The Mobile Home Park

The Florida Sanitary Code specifies that the parks should be
located on a well-drained site which will dry quickly following a
rain. Many of the older parks are located in less desirable spots,
near industrial plants, railroads, airports or busy highways. Some
of the better parks are located in quiet areas off the main high-
ways, and yet they maintain a full complement of trailers through

(Opposite page, top) A campsite in a state park is equipped with garbage
cans and a centrally-located building which houses toilets and showers ' in
background). Some mobile home parks (bottom) are equipped to cater to
travel trailers which have become popular with the touring American public.

FLORIDA HEALTH NOTES • 311

I

'■ I

1

Travel Trailers and Campers

More and more Florida and non-Florida families are faking vaca
tions in the state with trovel trailers and campers just large enough
for sleeping and/or cooking. People who travel in these need showers
and toilet facilities but few mobile home parks are equipped to provide §
these services. Some parks are making space and facilities available
for travel trailers; however, the demand is seasonal and during the
cooler months these parks are crowded.

Twenty-four state parks in Florida provide a limited number of
spaces for tent and trailer camping. On weekends and holidays these
facilities are jammed beyond the planned number of campers. Because
the parks operate on a first come-first served basis, many people are
turned away or allowed to camp along the roads of the park.

j

to care for and frequently the mobile home park does this for the
residents.

The cost of a mobile home ranges upward from $8500; some
with screened rooms ami private swimming pools may cost as much
as $25,000 — or more. Furniture may or may not come with the
trailers from the mobile home factory. These factories generally
do not manufacture furniture. In modern mobile home parks, the
owners may set up models similar to those in a housing subdivision
and sell from these models. Some park operators, as a sideline
business, decorate the trailers to suit the tastes of the buyer. Other
mobile home parks are connected to trailer sales lots and the
trailers are merely moved into the parks. Sometimes the trailers
are hauled a short distance to another mobile home park the buyer
prefers or the trailers may be moved many hundreds of miles. The
cost of moving a trailer may run as high as $300 or more — depend-
ing upon the distance and such attachments as cabanas, awnings
and carports which must be removed and then re-attached.

The Mobile Home Park

The Florida Sanitary Code specifies that the parks should be
located on a well-drained site which will dry quickly following a
rain. Many of the older parks are located in less desirable spots,
near industrial plants, railroads, airports or busy highways. Some
of the better parks are located in quiet areas off the main high-
ways, and yet they maintain a full complement of trailers through

(Opposite page, fop I A campsite in a state park is equipped with garbage
cans and a centrally-located building which houses toilets and showers (in
background 1 . Some mobile home parks (bottom) are equipped to cater to
travel trailers which have become popular with the touring American public.

FLORIDA HEALTH NOTES • 311

A Pinellas County mobile home pork is packed with several hundred trailers.
Many of these are permanently situated but others can be moved at the
discretion of the owners.

endorsements given by people who have lived in the parks or ad-
vertisements in trailer magazines.

The area of the mobile home park should be big enough to ac-
commodate the permitted number of trailer spaces, necessary roads
and parking spaces for motor vehicles. The space for independent
trailers must contain a minimum of 2400 square feet and be at least
40 feet wide. Despite this requirement, some parks have trouble
accommodating the larger 70- foot models. Space for dependent

312

FLORIDA HEALTH NOTES

i

trailers must have at least 1200 square feet and be a minimum of
30 feet wide. The better parks allow more than the minimum
space, and they have an appearance of spaciousness which older,
less well-kept parks do not have.

The Sanitary Code requires that there be a minimum of 10 feet
between trailers or any enclosed room and between trailers and park
buildings, except a dependent trailer served by its own toilet or
utility building. A five-foot space is required between any trailer,
its cabana and the exterior boundary of the park; all trailers and
additions should be placed so as not to obstruct public walkways
and streets.

Mobile home parks should be designed to give all trailer spaces
access to roads. If off-street parking is provided in new parks, the
streets should have a minimum width of 25 feet; otherwise, the
streets should be at least 30 feet wide. Perimeter roads, which
have trailers on one side, should be 20 feet wide.

Many county zoning requirements exceed the requirements of
the Florida Sanitary Code and therefore would be effective when
more stringent.

Rental space in mobile home parks usually ranges from $16 to
$66 a month. Waterfront space in luxurious parks in some resort
cities may run much higher. The lower priced parks, which are
usually older, have less to offer their residents. They may lack
paved streets, have inadequate parking space for large trailers,
have no concrete slabs for entrance ways or cabanas and provide no
recreational facilities. The better parks have all of these facilities
plus connected propane gas and electricity which are metered
separately to each trailer.

FLORIDA HEALTH NOTES

313

1

A Pinellas County mobile home park is pocked with several hundred trailers.
Many of these are permanently situated but others can be moved at the
discretion of the owners.

endorsements (riven by people who have lived in the parks or ad-
vertisements in trailer magazines.

The area of the mobile home park should be big enough to ac-
commodate the permitted number of trailer spaces, necessary roads
and parking spaces for motor vehicles. The space for independent
trailers must contain a minimum of 2400 square feet and be at least
40 feet wide. Despite this requirement, some parks have trouble
accommodating the larger 70-foot models. Space for de|iendent

312

FLORIDA HEALTH NOTES

trailers must have at least 1200 square feet and be a minimum of
30 feet wide. The better parks allow more than the minimum
space, and they have an appearance of spaciousness which older,
less well-kept parks do not have.

The Sanitary Code requires that there be a minimum of 10 feet
between trailers or any enclosed room and between trailers and park
buildings, except a dependent trailer served by its own toilet ox
utility building. A five-foot space is required between any trailer,
its cabana and the exterior boundary of the park; all trailers and
additions should be placed so as not to obstruct public walkways
and streets.

Mobile home parks should lie designed to give all trailer spaces
access to roads. If off-street parking is provided in new parks, the
streets should have a minimum width of 25 feet; otherwise, the
streets should be at least 30 feet wide. Perimeter roads, which
have trailers on one side, should be 20 feet wide.

Many county zoning requirements exceed the requirements of
the Florida Sanitary Code and therefore would be effective when
more stringent.

Rental space in mobile home parks usually ranges from $16 to
$65 a month. Waterfront space in luxurious parks in some resjrt
cities may run much higher. The lower priced parks, which are
usually older, have less to offer their residents. They may lack
paved streets, have inadequate parking space for large trailers,
have no concrete slabs for entrance ways or cabanas and provide no
recreational facilities. The better parks have all of these facilities
plus connected propane gas and electricity which are metered
separately to each trailer.

FLORIDA HEALTH NOTES • 313

Many mobile home parks which cater to retired people do not
allow children or pets. Some of the better parks may set aside part
of the area for families with children. One such park in a Florida
city provides a family section separated from the rest of the park
by the recreational center, swimming pool and yacht basin.

The County Health Department's Responsibility

Some of the major health problems with mobile trailer parks
are trash and litter around trailers, which means poor housekeep-
ing on the part of the residents and park manager, and improper
sewage disposal or connections to the sewerage system. The older
parks are the ones which give the most problems because of too
little space and poor facilities and drainage. Plot plans for new
parks are designed in cooperation with the County Health Depart-
ment's environmental health section and must also be approved
by either the city or county zoning departments if applicable. Water

Trailers of various sizes are parked helter-skelter in a a old trailer park.
These spaces do nor have concrete entranceways, cabanas or the luxuries of
newer mobile home parks.

314

FLORIDA HEALTH NOTES

■•<**

This up-to-date mobile home park furnishes its residents with this laundry
center which includes automatic washers and dryers.

and sewage aspects of the plans are also approved by the county
sanitary engineer, if the County Health Department has one, or
the State Board of Health's Bureau of Sanitary Engineering.

Prior to construction of a new park, the owner or operator must
submit to the County Health Department plans which show the
layout of the area and dimensions of the tract of land ; the number,
location and size of trailer spaces ; the location and width of streets
and walkways ; the floor plans for permanent buildings, such as
recreational buildings, to be built, including plumbing fixtures ; and
the plans for water supply and sewage disposal.

FLORIDA HEALTH NOTES

315

■

Many mobile home porks which cater to retired people do not
allow children or pets. Some of the better parks may set aside part
of the area for families with children. One such park in a Florida
city provides a family section separated from the rest of the park

by the recreational center, swimming pool ami yacht basin.

The County Health Department's Responsibility

Some of the major health problems with mobile trailer parks
are trash and litter around trailers, which meatus poor housekeep-
ing on the part of the residents and park manager, and Improper
sewage disposal or connections to the sewerage system. The older
parks are the ones which give the most problems because of too
little space and poor facilities ami drainage. Plot plans for new
parks are designed in cooperation with the County Health Depart-
ment's environmental health section and must also he approved
by either the city or county zoning departments if applicable. Water

Trailers ot various sizes are parked helter-skelter in an old trailer pork
These spaces do nor have concrete entranceways, cabanas or the luxuries of
newer mobile home parks

314

FLORIDA HEALTH NOTES

This up-to-date mobile home park furnishes its residents with this laundry
center which includes automatic washers and dryers.

and sewage aspects of the plans are also approved by the county
.sanitary engineer, it" the County Health Department has one, of
the State Board of Health's Bureau uf Sanitary Engineering.

Prior to construction of a new park, the owner or operator must
submit to the County Health Department plans which show the
layout of the area and dimensions of the tract of land; the number,
location and size of trailer spaces; the location and width of streets
and walkways; the floor plans for permanent buildings, such as
recreational buildings, to he built, including plumbing fixtures; and
the plans for water supply and sewage disposal.

FLORIDA HEALTH NOTES

315

A sanitarian checks the
sewage pipe connection to a
modern mobile home. (Op-
posite page). In another
older trailer park, he checks
a toilet in a central bath
house which also includes
two lavatories.

These plans are approved by the County Health Department.
The local sanitarian checks on the construction as it progresses, and
when the park is completed, he assists the owner to obtain the
needed permit.

Periodically the sanitarian checks to see if there have been any
changes in the park, if there are any violations of the Florida
Sanitary Code, or if there are more trailers permitted than the
number for which the park is allowed. Prior to expanding or add-
ing trailer spaces, the owner must apply for another permit. Each
park must have a supervised office where both the State Board of
Health and the mobile home park regulations are posted, com-
plaints answered and registrations of residents maintained. The
registrations should include:

names and addresses of all trailer occupants ;
316 • FLORIDA HEALTH NOTES

make, model and license number of each motor vehicle and
trailer ;

state, territory or county issuing the trailer license ; and

date of arrival and departure of each trailer.

The registration is for the benefit of the park residents. For ex-
ample, the mobile home park manager would be able to know where
to contact the owners of a trailer should something happen, such as
hurricane damage, while the owners are away. Some mobile homes
are parked all year in the park, even while the owners spend part
of the year in other parts of the United States or abroad; some

FLORIDA HEALTH NOTES

317

A sanitarian checks the
sewage pipe connection to a
modern mobile home. I Op-
posite page I . In another
older trailer park, he checks
a toilet in o central bath
house which also includes
two lavatories.

These plans are approved by the County Health Department.
The local sanitarian checks on the construction as it progresses, and
when the park is completed, he assists the owner to obtain the
needed permit.

Periodically the sanitarian checks to see if there have been any
changes in the park, if there are any violations of the Florida
Sanitary Code, or if there are more trailers permitted than the
number for which the park is allowed. Prior to expanding or add-
ing trailer spaces, the owner must apply for another permit. Each
park must have a supervised office where both the State Board of
Health and the mobile home park regulations are posted, com-
plaints answered and registrations of residents maintained. The
registrations should include:

names and addresses of all trailer occupants ;
316 • FLORIDA HEALTH NOTES

make, model and license number of each motor vehicle and
trailer ;

state, territory or county issuing the trailer license; and

date of arrival and departure of each trailer.

The registration is for the benefit of the park residents. For ex-
ample, the mobile home park manager would be able to know where
to contact the owners of a trailer should something happen, such as
hurricane damage, while the owners are away. Some mobile homes
are parked all year in the park, even while the owners spend part
of the year in other parts of the United States or abroad; some

I

FLORIDA HEALTH NOTES

317

■

■ll

I

1

A new mobile home pork (left! has an electric meter for each trailer space.
A sanitarian (above) looks at the wiring to a master meter in an old trailer
park which submeters each trailer for an equal amount of electricity, wheth-
er or not it uses it.

trailers are stored on lots set aside for this purpose; and others are
rented by the park operator to offset the cost of the parking space.
Some mobile home parks own a few trailers which are available as
rentals.

What the Sanitarian Looks For

Water supply — Each mobile home should have access to ade-
quate, safe and potable water with a service connection to each
trailer. If the park has its own private water supply, the sanitarian
takes water samples periodically for testing by the state laborator-

318

FLORIDA HEALTH NOTES

ies. If public water is available, the park must be connected to this
system.

Sewage disposal — If a public sewerage system is available, the
mobile home park must be connected to it; should the park use
septic tanks, there must be no overflow during the rainy season.
The park manager should see that each trailer's connection to the
park's sewerage system is tight and of an easily removable, acid
resistant, semi-rigid or flexible material. Frequently the sanitarian
checks the trailers for loose or improper connections. All plumbing
must comply with the Florida Sanitary Code and local ordinances.
Trailers which do not have plumbing complying with the Sanitary
Code should not be connected by the manager. When a trailer is
removed, the sewer outlet must be tightly capped.

Toilet facilities — A park catering to dependent trailers or
trailers making a one-night stop must have toilet facilities avail-
able. They must also be available in the park's recreational or public
gathering buildings.

Garbage and refuse disposal — A park manager needs to work
out a system of collecting, storing, and disposing of refuse and
garbage so that there are no health hazards, rodent harborage, in-
sect breeding or accidents. Garbage should be stored in tightly
covered containers. Some parks have racks for holding 20-gallon
cans or Dempster Dumps ters located throughout the park ; others
have garbage cans located at each trailer. Refuse should not be
allowed to accumulate but be picked up at least twice a week ; burn-
ing of refuse in the park should not be allowed.

Managers sometimes have difficulty with residents who store
lumber and other material under their trailers. The better parks
counteract this by having the trailers skirted with fancy concrete
blocks or other decorative material which allows the circulation of
air underneath the trailers but discourages the collection of trash.

FLORIDA HEALTH NOTES • 319

Shrubs ©r flowers are sometimes used but they often die or are
neglected.

Insect and rodent control — The manager should see that no
standing water be allowed to collect where insects can breed and the
park should be kept free of refuse and debris which harbor rodents.
If rodents are known to infest the park, the manager should take
steps to have them exterminated. Weeds should be controlled and
good housekeeping maintained.

Electricity — The parks must comply with local electrical codes
and ordinances. Some trailer parks have a master electric meter
and submeter electricity to each lot. However, utility companies
prefer to bill each trailer separately and directly. Sanitarians some-
times have to check electrical outlets which supply at least 110 volts
to each trailer. If the installations are not safe, he asks the man-
ager to correct the situation.

Some mobile home
parks have garbage
cans at each trail-
er. This one has a
unique way of keep-
ing such cans well
organized behind
hedges.

320

FLORIDA HEALTH NOTES

The trailer owner
who practices poor
housekeeping is a
problem to both the
park manager and
the County Health
Department. Such
pries of belongings
harbor disease-
carrying rodents
and are fire haz-
ards.

Laundries — Some parka provide automatic washers and dryers,
located in a central building, for the use of the park's residents.
Where public laundry facilities are not available in the neighbor-
hood, the mobile home trailer park usually provides such services
with at least a two-compartment stationary laundry tub with hot
and cold running water.

Pets — Most mobile home parks do not allow pets; where they
do the pets are required to be kept on a leash and not allowed to
run at large. All pets which live in parks are required to have up-
to-date rabies immunizations and their owners must have current
rabies certificates in their possession.

The Future of Mobile Home Living in Florida

The State Board of Health and County Health Departments
view mobile home parks as "housing situations" and therefore are

FLORIDA HEALTH NOTES

321

Shrubs or flowers are sometimes used but they often die or
neglected.

are

Insect and rodent control — The manager should see that no
standing water be allowed to collect where insects can breed and the
park should be kept free of refuse and debris which harbor rodents.
If rodents are known to infest the park, the manager should take
steps to have them exterminated. Weeds should Ije controlled and
good housekeeping maintained.

Electricity — The parks must comply with local electrical codes
and ordinances. Some trailer parks have a master electric meter
and submeter electricity to each lot. However, utility companies
prefer to bill each trailer separately and directly. Sanitarians some-
times have to check electrical outlets which supply at least 110 volts
to each trailer. If the installations are not safe, he asks the man-
ager to correct the situation.

*3fiEfcli»P p

Some mobile home
parks hove garbage
carts at each trail-
er. This one has a
unique way of keep-
ing such cans well
organized behind
hedges.

320

FLORIDA HEALTH NOTES

The trailer owner
who practices poor
housekeeping is a
problem to both the
park manager and
the County Health
Department. Such
piles of belongings
harbor disease-
carrying rodents
and ore fire haz-
ards.

&

A..' 1 '.

Laundries — Some parks provide automatic washers and dryers,
located in a central building, for the use of the park's residents.
Where public laundry facilities are not available in the neighbor-
hood, the mobile home trailer park usually provides such services
with at least a two-corn partment stationary laundry tub with hot
and cold running water.

Pets — Most mobile home parks do not allow pets; where they
do the pets are required to be kept on a leash and not allowed to
run at large. All pets which live in parks are required to have up-
to-date rabies immunizations and their owners must have current
rabies certificates in their possession.

The Future of Mobile Home Living in Florida

The State Board of Health and County Health Departments
view mobile home parks as "housing situations" and therefore :n*e

FLORIDA HEALTH NOTES

321

interested in the environmental health and safety of the residents.
The primary purposes are to see that people have safe water and
proper sewage disposal; the space for trailers, width of roads and
control of pets are for safety.

These health regulations are important to modern mobile home
living which has a big future in Florida. Low maintenance and the
great number of conveniences make this type of living wonderful
for retired people. In addition, it offers a congenial, informal way of
life. People who are devoted to mobile home living are working
with the County Health Departments and the State Board of Health
to upgrade and maintain a high standard of mobile home park
communities.

How the Number of Trailer Parks Has Grown

Mobile home living has become an important way of life in Florida. <
In 1948, the State Board of Health issued permits to 225 trailer camps. £
£ In 1956, the number of trailer parks had grown to 686 with spaces for
& 12,900 independent and 3486 dependent trailers. As mentioned else-
& where in this HEALTH NOTES, the state now has 2523 mobile home
4 parks with space for over 105,700 independent trailers and 4628 &
^ dependent trailers. Because of the mild climate, the beauty of the
{s parks and the informal way of life, the trend toward mobile home
§ living will continue.

I

322 • FLORIDA HEALTH NOTES

"i"""— ~^^"^^^

n n

VOL |fl
SEP" Mitt

OL WASTES
— tfo tkifd Pdtuth*

interested in the environmental health and safety of the residents.
The primary purposes are to see that people have safe water and
proper sewage disposal; the space for trailers, width of roads and
control of pets are for safety.

These heaith regulations are important to modern mobile home
living which has ;i liig future in Florida. Low maintenance and the
great numl>ei of conveniences make this type of living wonderful
for retired people. In addition, it offers a congenial, informal way of
life. People who are devoted to mobile home living are working
witli the County Health Departments and the State Board of Health
to upgrade and maintain a high standard of mobile home park
communities.

% I

How the Number of Trailer Parks Has Grown

Mobile home living hos become on important way of life in Florida, j

In 1948, the State Board of Health issued permits to 225 trailer camps. £
x In 1956, the number of trailer porks hod grown to 686 with spaces for
£ 12,900 independent and 3486 dependent trailers. As mentioned else-
A where in this HEALTH NOTES, the state now hos 2523 mobile home

^ parks with space for over 105,700 independent trailers ond 4628 §

^, dependent trailers. Because of the mild climate, the beauty of the &

^ parks ond the informal way of life, the trend toward mobile home ^

4 living will continue. §

322

FLORIDA HEALTH NOTES

p

FLORIDA

HEALTH
NOTES!

*Q vlE 59 — NO. 9
S EP 4BER 1967

SOLID WASTES

-the third Fellatio*

m

i
t

The proper way for the
housewife to dispose of gar-
bage is to drain it, wrap it
in newspaper (left) and
place it in a water-tight
container (below).

fi

(Cover photo i The proper
disposal of solid wastes is
a problem for many com-
munities. The picking up
and carrying of garbage to
a disposal site is the most
expensive part of the opera-
tion.

.

SOLID WASTES--

— the third Pollution

The average Floridian places his garbage and rubbish in a con-
tainer and takes the can to the curb or leaves it in the alley where
it is emptied. He may allow the can to fill up and then take it out
and empty it at a local dump, or he may empty it along the high-
way. Regardless of what he does, he may not give a second thought
as to what happens next to his garbage and rubbish.

We hope you are not the average Floridian. But still, do you
know what happens to your garbage? Do you know what kind
of rubbish disposal service your community has? Garbage and
rubbish are solid wastes and solid waste is a form of pollution
which ranks a close third to air and water pollution.

This waste is the result of a high standard of living and ad-
vanced technology; it is the consequence of rising levels of na-
tional production and consumption — coupled with a vast urban
population which has no means of disposing of its solid wastes on
a personal basis. Because the city dweller does not have any way
of getting rid of his solid waste, it therefore becomes the responsi-
bility of his community.

The disposal of solid waste creates a problem that overwhelms
the waste handling and disposal resources and facilities of nearly
every community in the state. Unless steps are taken to properly
dispose of our garbage and rubbish, we will find ourselves reach-
ing for the planets and stars while standing knee-deep in trash.

A common attitude of many communities is the "dirt under
the rug" approach. As long as the refuse does not pile too deep
along the curbs and in the alleys of our cities, or if it is merely
taken to the city dump where the refuse only annoys the nearby

FLORIDA HEALTH NOTES • 327

The proper way for the
housewife to dispose of gar-
bage is to drain it, wrap it
in newspaper (left) and
place it in a water- tight
container (below).

'Cover photo) The proper
disposal of solid wastes is
a problem for many com-
munities. The picking up
and carrying of garbage to
a disposal site is the most
expensive part of the opera-
tion.

SOLID WASTES-

— the third PcttutfoH

The average Floridian places his garbage and rubbish in a con-
tainer and takes the can to the curb or leaves it in the alley where
it is emptied. He may allow the can to fill up and then take it out
and empty it at a local dump, or he may empty it along the high-
way. Regardless of what he does, he may not give a second thought
as to what happens next to his garbage and rubbish.

We hope you are not the average Floridian. But still, do you
know what happens to your garbage? Do you know what kind
of rubbish disposal service your community has? Garbage and
rubbish are solid wastes and solid waste is a form of pollution
which ranks a close third to air and water pollution.

This waste is the result of a high standard of living and ad-
vanced technology; it is the consequence of rising levels of na-
tional production and consumption— coupled with a vast urban
population which has no means of disposing of its solid wastes on
a personal basis. Because the city dweller does not have any way
of getting rid of his solid waste, it therefore becomes the responsi-
bility of his community.

The disposal of solid waste creates a problem that overwhelms
the waste handling and disposal resources and facilities of nearly
every community in the state. Unless steps are taken to properly
dispose pf^our garbage and rubbish, we will find ourselves reach-
ing for the planets and stars while standing knee-deep in trash.

A common attitude of many communities is the "dirt under
the rug" approach. As long as the refuse does not pile too deep
along the curbs and in the alleys of our cities, or if it is merely
taken to the city dump where the refuse only annoys the nearby

FLORIDA HEALTH NOTES • 327

residents, many communities try to ignore the problem and hope
it will go away. Florida has a number of city and county dumps
billowing clouds of smoke — air pollution — a few antiquated and
overburdened incinerators, acres of junked automobiles and a great
deal of industrial waste contributing to the blight of the com-
munity.

The burning dumps and improperly operated incinerators con-
tribute to air pollution and the dumps add to the possible pollution
of groundwater or surface streams. All of these increase the
hazards to health, contribute to urban and suburban blight, affront
our sense of smell, and offend our concept of beauty.

Solid waste disposal is a civic problem when a community can-
not or will not take the necessary steps to properly dispose of
its garbage and waste; the individual who dumps junk in illegal
places and tosses beer cans and sacks of garbage along the high-
way and streets is a social menaee.

Some progressive counties and cities in Florida are taking steps
to eradicate the unsightly and filthy dumps by erecting modern
incinerators and operating sanitary landfills properly.

This issue of Florida Health Notes will tell you about the im-
portance of the solid waste problem, the types of solid wastes,
the methods of collection, some of the various means of disposal,
the salvaging of wastes, and what you can do to help combat this
problem.

FLORIDA HEALTH NOTES

Published monthly by the Florida State Board of Health, Wilson T. Sowder, M.D., M.P.H.,
Stat» Heolth Officer, Publication office^ Box 210, Jacksonville, Florida 3220 1. Second class
postage paid at Jacksonville, Florida. This publication is for individuals and institutions with
an interest in the state's health programs. Permission is given to quote ony story providing
credit is given to the Florida Stote Board of Health. Editor: Robert A. Schoonover, M.A.,
Division of Health Education.

VOLUME $9 — NO. 6 SEPTEMBER 1967

328 • FLORIDA HEALTH NOTES

A public health worker
surveys a field littered
with trash discarded by a
thoughtless public.

Kinds of Solid Wastes

Solid waste is defined as all of the community's wastes, includ-
ing 1 those semi-Hquid or wet wastes whose moisture content is not
enough to make the material free flowing.

These wastes are commonly classified as:

Garbage — putrescible wastes (that which has a tendency to
decay) from the preparing cooking and serving of foods; from
produce markets, and from the processing, canning and quick-
freezing industries.

Rubbish — nonputrescible wastes of a combustible and/or non-
combustible nature, including paper, wood, cloth products, rubber,
leather, garden wastes, metals, metallic and plastic products,
masonry, ceramics and glass.

Ashes — the residue from on-site incinerators or refuse ma-
terial, including cinders and fly ash from burning solid fuels —
wood, coal and coke.

Offal — waste animal matter from butcher, slaughter and pack-
ing houses.

FLORIDA HEALTH NOTES

329

residents, many communities try to ignore the problem and hope
it will go away. Florida has a number of city and county dumps
billowing clouds of smoke — air pollution — a few antiquated and
overburdened incinerators, acres of junked automobiles and a great
deal of industrial waste contributing to the blight of the com-
munity.

The burning dumps and improperly operated incinerators con-
tribute to air pollution and the dumps add to the possible pollution
of groundwater or surface streams. All of these increase the
hazards to health, contribute to urban and suburban blight, affront
our sense of smell, and offend our concept of beauty.

Solid waste disposal is a civic problem when a community can-
not or will not take the necessary steps to properly dispose of
its garbage and waste; the individual who dumps junk in illegal
places and tosses beer cans and sacks of garbage along the high-
way and streets is a social menace.

Some progressive counties and cities in Florida are taking steps
to eradicate the unsightly and filthy dumps by erecting modern
incinerators and operating sanitary landfills properly.

This issue of Florida Health Notes will tell you about the im-
portance of the solid waste problem, the types of solid wastes,
the methods of collection, some of the various means of disposal,
the salvaging of wastes, and what you can do to help combat this
problem.

FLORIDA HEALTH NOTES

Published monthly by the Florida State Board of Health, Wilson T. Sowder, M.O., M.P.H.,
State Health Officer, Publication office. Box 210, Jacksonville, Florida 32201. Second class
postage pold at Jacksonville, Florida. This publication is for individuals and institutions with
an interest in the state's health programs. Permission is given to quote any story providing
credit is given to the Florida State Board of Health. Editor: Robert A, Schoonover, M.A.,
Division of Health Educotion.

VOLUME 59 — NO. 9 SEPTEMBER 1967

328 • FLORIDA HEALTH NOTES

A public health worker
surveys a field littered
with trash discarded by a
thoughtless public.

Kinds of Solid Wastes

Solid waste is defined as all of the community's wastes, includ-
ing those semi-liquid or wet wastes whose moisture content is not
enough to make the material free flowing.

These wastes are commonly classified as;

Garbage — putrescible wastes (that which has a tendency to
decay) from the preparing cooking and serving of foods; from
produce markets, and from the processing, canning and quick-
freezing industries.

Rubbish — nonputrescible wastes of a combustible and/or non-
combustible nature, including paper, wood, cloth products, rubber,
leather, garden wastes, metals, metallic and plastic products,
masonry, ceramics and glass.

Ashes — the residue from on-site incinerators or refuse ma-
terial, including cinders and fly ash from burning solid fuels —
wood, coal and coke.

Offal — waste animal matter from butcher, slaughter and pack-
ing houses.

FLORIDA HEALTH NOTES

329

Manure — body wastes from animals or fowls, including clean-
ings from barns, stables, corrals, pens or chicken coops.

Special wastes — include street refuse; demolition and construc-
tion debris; dead animals; solid wastes from sewage treatment
plants; pathological and anatomical wastes from hospitals, climes
and medical centers; industrial wastes and bulky wastes, includ-
ing automobiles, stoves, refrigerators, furniture and large trees.

Miscellaneous wastes — include small Christmas trees, rubber
tires, various plastic materials and cemetery floral pieces.

Solid wastes may also be classified according to source:

Domestic refuse from households and apartment houses ;

Municipal refuse from street litter, playgrounds, zoos, schools
and solid wastes from sewerage systems ;

Commercial refuse from businesses which operate for a profit,
including office buildings, markets and restaurants; and

Despite a sign telling where to take solid wastes, people continue to leave
their trash at this closed dump.

CLOSED TEMP

PLEASE UK ML2

#2 ^ET-J

Industrial wastes from factories, processing 1 plants, repair and
cleaning establishments, refineries and rendering plants.

The current production of solid wastes in Florida amounts to
about 4.5 pounds per person each day or about 13,500 tons daily
for the entire population. Through the increased growth and the
use of more disposable containers, it is estimated the total daily
output will be twice this amount by 1980.

Public Health Aspects

Why are the State Board of Health and County Health Depart-
ments concerned about the disposal of solid wastes?

Flies are quickly attracted to garbage, offal and manure and a
cubic foot of suitable breeding material may produce 70,000 fly
larvae. Flies infest garbage in open cans that are not picked up
but once a week. The larvae are usually concealed in the lower
parts of the can so that the householder is unaware of their

Solid waste disposal is not only a problem on earth, but it is much §
more of a problem in space. During the Gemini-5 astronauts' eight-
& day mission, the stowage of their solid waste was a principal problem

presence. These larvae are carried away when the garbage is col-
lected. Where a can of garbage remains a week or longer, flies
can emerge to plague a community. It has been shown experi-
mentally that they are capable of carrying bacteria of such diseases
as typhoid fever, cholera, summer diarrhea, dysentery, tuberculosis
and anthrax, as well as the eggs of intestinal worms on their feet.

Solid waste disposal is important in rodent and mosquito con-
trol and therefore much of the work is carried on under the State
Board of Health's arthropod control program. Garbage serves as
a chief food source for rats and mice; piles of trash, old automo-
biles and other cast-off materials serve as homes for rodents. These
pests can transmit plague, rabies, murine typhus fever and
other diseases. Open cans and bottles, tires and other trash catch
and hold water in which domestic mosquitoes breed and these pests
carry yellow fever, dengue, mosquito-borne encephalitis and fil-
ariasis.

FLORIDA HEALTH NOTES • 331

Manure — body wastes from animals or fowls, including- clean-
ings from barns, stables, corrals, pens or chicken coops.

Special wastes — include street refuse ; demolition and construc-
tion debris; dead animals; solid wastes from sewage treatment
plants; pathological and anatomical wastes from hospitals, clinics
and medical centers; industrial wastes and bulky wastes, includ-
ing automobiles, stoves, refrigerators, furniture and large trees.

Miscellaneous wastes — include small Christmas trees, rubber
tires, various plastic materials and cemetery floral pieces.

Solid wastes may also be classified according to source:

Domestic refuse from households and apartment houses ;

Municipal refuse from street litter, playgrounds, zoos, schools
and solid wastes from sewerage systems ;

Commercial refuse from businesses which operate for a profit,
including office buildings, markets and restaurants; and

Despite a sign telling where to take solid wastes, people continue to leove
their trash at this closed dump.

CLOSED TEMP

PLEASE USE NO 2 01
LOCATED OH OUNNSCIWRi

»S?~

w;

.r-

Industrial wastes from factories, processing plants, repair and
cleaning establishments, refineries and rendering plants.

The current production of solid wastes in Florida amounts to
about 4.5 pounds per person each day or about 13,500 tons daily
for the entire population. Through the increased growth and the
use of more disposable containers, it is estimated the total daily
output will be twice this amount by 1980.

Public Health Aspects

Why are the State Board of Health and County Health Depart-
ments concerned about the disposal of solid wastes?

Flies are quickly attracted to garbage, offal and manure and a
cubic foot of suitable breeding material may produce 70,000 fly
larvae. Flies infest garbage in open cans that are not picked up
but once a week. The larvae are usually concealed in the lower
parts of the can so that the householder is unaware of their

Solid waste disposal is not only a problem on earth, but it is much §
^ more of a problem in space. During the Gemini-5 astronauts' eight- §
£ day mission, the stowage of their solid waste was a principal problem. §

presence. These larvae are carried away when the garbage is col-
lected. Where a can of garbage remains a week or longer, flies
can emerge to plague a community. It has been shown experi-
mentally that they are capable of carrying bacteria of such diseases
as typhoid fever, cholera, summer diarrhea, dysentery, tuberculosis
and anthrax, as well as the eggs of intestinal worms on their feet.

Solid waste disposal is important in rodent and mosquito con-
trol and therefore much of the work is carried on under the State
Board of Health's arthropod control program. Garbage serves as
a chief food source for rats and mice; piles of trash, old automo-
biles and other cast-off materials serve as homes for rodents. These
pests can transmit plague, rabies, murine typhus fever and
other diseases. Open cans and bottles, tires and other trash catch
and hold water in which domestic mosquitoes breed and these pests
carry yellow fever, dengue, mosquito-borne encephalitis and fil-
ariasis.

FLORIDA HEALTH NOTES • 331

Where backyard burning takes the place of the proper solid
waste collection and disposal, there is danger of fire and home ac-
cidents. Papers, rags and trash collected in attics and storage rooms
can also lead to fires. Discarded items that are not stored properly
or are not promptly disposed of are particularly attractive to chil-
dren. Unsanitary and unsafe conditions in yards and home refuse
storage areas have resulted in thousands of minor and severe ac-
cidents.

A 13-year-old boy, while playing in an alley with his friends,
found several milk bottles with "some fluid" in them. Another boy
threw a lighted match into one of the bottles and the resulting
explosion caused third-degree burns of the boy's face and a long
period of hospitalization.

In addition to disease-carrying vectors and accidents, improper
storage, handling and disposal of solid wastes lead to another health
problem — air pollution. Large quantities of smoke and odors are
produced where burning is used to reduce the volume of solid
wastes in open dumps, improperly designed and operated munic-
ipal incinerators, backyard trash burners and on-site incinerators.

Serious water pollution can materialize from improper solid
waste disposal. Where refuse is deposited on land, rainwater can
filter through the matter and into the groundwater. Drainage
from improperly stored barnyard wastes may also leach through
into the water table.

The danger of trichinosis from pork has been reduced through
a Florida statute which requires that garbage be cooked before
being fed to pigs. Prior to the starting of such a feeding operation,
the farmer must obtain a permit from the State Department of
Agriculture with the approval of the County Health Department.

A Society of Discarded Abundance

The modern American civilization may go down in history as
one known for its piles of disposable bottles, cans, packages and
syringes ; its acres of discarded and outdated automobiles ; and its
mountains of rubble from demolition and construction. Do you

332 • FLORIDA HEALTH NOTES

Piles of discarded auto-
mobiles serve as mansions
for disease-carrying ro-
dents.

realize how much waste paper, boxes and plastic bottles you dis-
card?

The packaging- industry has made a tremendous contribution to
the safe and healthful distribution of a wide variety of foods, wash-
ing products and household items. Disposable bottles and cans for
soft drinks, plastic containers for soaps and bleaches, pressurized
cans for shaving cream and hair sprays, and plastic bags and wire
hangers for clothing have made life easier for the consumer and
provided more profit for the manufacturer. Packaging officials
report in the near future that some 60 per cent of all soft drinks
will be in nonreturaable bottles. Then our streets will be more
littered than at present, dumps will be clogged, and incinerators
full of bottles or melted glass.

While paper and cardboard containers will burn, plastic bottles
that go through the disposal system do not break down (or decay)
and therefore end up in the sanitary landfill or dump unchanged.
Tin cans will oxidize (decay) in time; disposable aluminum cans
will develop an aluminum oxide coating but this is as far as the
deterioration process goes. The packaging industry has given no
consideration to the solid waste disposal problem. As long as it
can make a profit and provide conveniences for the consumer, it
can be expected to turn out an abundance of discardable material.

FLORIDA HEALTH NOTES • 333

Studies need to be carried out to consider and develop alternate
solutions to the problem. Bottle shape might be changed so that
they can be more easily cleaned; tumbler-shaped containers with
spill-proof polyethylene tops for milk, beer and other beverages
might be easier to clean and reuse. More containers which are
made to be returned for a deposit refund could reduce the number
of cans and bottles discarded on our streets. Double and triple
wrappings of packages might be eliminated through the use of
newly developed packaging material.

Collecting: Solid Wastes

The population growth and the concentration of people in
metropolitan areas are the main reasons that refuse disposal has
become an acute problem. Rapidly expanding communities find
that the cost of collecting and hauling solid waste to distant dis-
posal sites is becoming increasingly expensive. In fact the cost of
collecting is three or four times as much as the actual disposal.

Despite the ugly curbside garbage cans, the unsightly collection
trucks and crews, the pick-up noises (especially at night or in the
early morning hours), house-to-house collection services need to
continue. Although the home and commercial garbage grinders
have proven successful in some respects, the other kinds of solid
wastes produced by the household still need to be collected. Com-
mercial and industrial collections, especially in business districts,

o r

Workers from a city
waste department cleon
up a pile of rubbish
placed at the curb by a
homeowner.

A front-end loader is used
by a city waste depart-
ment to pick up heavy
trash, such as abandoned
refrigerators and stoves.

are complicated by traffic, limited storage space, noise, odor and
health and safety hazards.

There are two collection systems in use in Florida :

The municipally operated service conducted by an appropriate
branch of the local government for which city residents are taxed ;
and

the franchised service, carried on by a private company, which
makes periodical pick-ups of garbage and rubbish and bills the
customers for the service.

Some residents of the franchised areas refuse to accept and
pay for the services of the private company and dispose of their
solid waste the best way they can— sometimes dumping it in illegal
dumps or along the highway. Because of the danger of disease,
the State Board of Health, County Health Departments and mos-
quito control districts discourage this practice.

Door-to-door collections are made in a wide variety of trucks.
The open-bed vehicle, which is used far too often, gives off odors,
collects insects, scatters papers, and does not hold much refuse.
The progressive communities and franchised operators are turning
to closed compaction trucks. While these vehicles have distinct ad-
vantages over the open-bed trucks, they are noisier, heavier and
costlier to purchase, maintain and operate. Besides the usual gar-

FLORIDA HEALTH NOTES

335

Studies need to be carried out to consider and develop alternate
solutions to the problem. Bottle shape might be changed so that
they can be more easily cleaned; tumbler-shaped containers with
spill-proof polyethylene tops for milk, beer and other beverages
might be easier to clean and reuse. More containers which are
made to be returned for a deposit refund could reduce the number
of cans and bottles discarded on our streets. Double and triple
wrappings of packages might be eliminated through the use of
newly developed packaging material.

Collecting Solid Wastes

The population growth and the concentration of people in
metropolitan areas are the main reasons that refuse disposal has
become an acute problem. Rapidly expanding communities find
that the cost of collecting and hauling solid waste to distant dis-
posal sites is becoming increasingly expensive. In fact the cost of
collecting is three or four times as much as the actual disposal.

Despite the ugly curbside garbage cans, the unsightly collection
trucks and crews, the pick-up noises {especially at night or in the
early morning hours), house-to-house collection services need to
continue. Although the home and commercial garbage grinders
have proven successful in some respects, the other kinds of solid
wastes produced by the household still need to be collected. Com-
mercial and industrial collections, especially in business districts,

Workers from a city
waste department clean
up a pile of rubbish
placed at the curb by a
homeowner.

A front-end loader is used
by a city waste depart-
ment to pick up heavy
trash, such as abandoned
refrigerators and stoves.

are complicated by traffic, limited storage space, noise, odor and
health and safety hazards.

There are two collection systems in use in Florida :

The municipally operated service conducted by an appropriate
branch of the local government for which city residents are taxed;
and

the franchised service, carried on by a private company, which
makes periodical pick-ups of garbage and rubbish and bills the
customers for the service.

Some residents of the franchised areas refuse to accept and
pay for the services of the private company and dispose of their
solid waste the best way they can— sometimes dumping it in illegal
dumps or along the highway. Because of the danger of disease,
the State Board of Health, County Health Departments and mos-
quito control districts discourage this practice.

Door-to-door collections are made in a wide variety of trucks.
The open-bed vehicle, which is used far too often, gives off odors,
collects insects, scatters papers, and does not hold much refuse.
The progressive communities and franchised operators are turning
to closed compaction trucks. While these vehicles have distinct ad-
vantages over the open-bed trucks, they are noisier, heavier and
costlier to purchase, maintain and operate. Besides the usual gar-

FLORIDA HEALTH NOTES

335

A closed compaction
truck, similar to the one
on the cover of this issue
of Florida Health Notes,
delivers its load of gar-
bage to a sanitary land-
fill . . .

bage pick-up, the collectors may pick up and dispose of yard litter,
newspapers, old furniture and worn out appliances which emanate
from a household. The collectors may make special trips once a
week to collect these items, or they may refuse to handle them en-
tirely.

When the route vehicle has stopped at each house, commercial
establishment or industrial plant to take on waste material and
completed its route or filled the truck, it proceeds to a place where
it deposits the contents. If it is a short distance to a dump, sani-
tary landfill or incinerator, there is no problem. However, in
metropolitan areas, the distance to the disposal place of solid wastes
may be great and therefore this adds to the overall cost. In
some Florida communities, waste material is taken by the route
trucks to a central location where it is placed in bins. The refuse
is then transferred to bulk haulers for the long trip to a distant
sanitary landfill or incinerator.

Each time the material is rehandled, the cost of the disposal
service goes up. The hauling of solid wastes in these bulk haulers
is further complicated by weight limits on highways and regula-
tions of the motor vehicle code which stipulates the gross tonnage
of large trucks.

336

FLORIDA HEALTH NOTES

The Offending Dumps

According to the Florida Sanitary Code, the disposal of gar-
bage, offal, dead animals and manure or rubbish or any mixture
thereof, can only be disposed of by incineration, burial, sanitary
landfill or other method approved by the State Board of Health.
The material cannot be disposed of by being placed in any natural
or artificial body of water or on the watershed of any surface
public water supply. It cannot be placed within a half-mile of any
house or business where it may become a sanitary nuisance or
menace to health, or dumped upon a Florida highway or alley or
within a half-mile of such roads, except where it has been treated
in a manner approved by the State Board of Health.

Nevertheless, one most common method of disposing of solid
waste is to dump it some place, either a spot along the road, which
is illegal, or at a place designated as a community dump. This
method is unsatisfactory because open dumps breed disease through
infestation by rodents and insects, are unsightly, give off odors and
contribute to air and water pollution. Some of these dumps are
disposal places for sludge from septic tanks and this makes the
situation even worse.

. . . where the garbage is
leveled off and packed
down by a bulldozer. In
this particular city-owned
landfill, dirt is hauled to
cover the waste.

-

'-'*$$

?»

A closed compaction
truck, similar to the one
on the cover of this issue
of Florida Health Nates,
delivers its load of gar-
bage to a sanitary land-
fill . . .

bage pick-up, the collectors may pick up and dispose of yard litter,
newspapers, old furniture and worn out appliances which emanate
from a household. The collectors may make special trips once a
week to collect these items, or they may refuse to handle them en-
tirely.

When the route vehicle has stopped at each house, commercial
establishment or industrial plant to take on waste material and
completed its route or filled the truck, it proceeds to a place where
it deposits the contents. If it is a short distance to a dump, sani-
tary landfill or incinerator, there is no problem. However, in
metropolitan areas, the distance to the disposal place of solid wastes
may be great and therefore this adds to the overall cost. In
some Florida communities, waste material is taken by the route
trucks to a central location where it is placed in bins. The refuse
is then transferred to bulk haulers for the long trip to a distant
sanitary landfill or incinerator.

Each time the material is rehandled, the cost of the disposal
service goes up. The haulinjr of solid wastes in these bulk haulers
is further complicated by weight limits on highways and regula-
tions of the motor vehicle code which stipulates the gross tonnage
of large trucks.

336

FLORIDA HEALTH NOTES

The Offending Dumps

According to the Florida Sanitary Code, the disposal of gar-
bage, offal, dead animals and manure or rubbish or any mixture
thereof, can only be disposed of by incineration, burial, sanitary
landfill or other method approved by the State Board of Health.
The material cannot be disposed of by being placed in any natural
or artificial body of water or on the watershed of any surface
public water supply. It cannot be placed within a half-mile of any
house or business where it may become a sanitary nuisance or
menace to health, or dumped upon a Florida highway or alley or
within a half-mile of such roads, except where it has been treated
in a manner approved by the State Board of Health.

Nevertheless, one most common method of disposing of solid
waste is to dump it some place, either a spot along the road, which
is illegal, or at a place designated as a community dump. This
method is unsatisfactory because open dumps breed disease through
infestation by rodents and insects, are unsightly, give off odors and
contribute to air and water pollution. Some of these dumps are
disposal places for sludge from septic tanks and this makes the
situation even worse.

. . . where the garbage is
leveled off and pocked
down by o bulldozer. In
this particular city-owned
landfill, dirt is hauled to
cover the waste.

The waste material in many open dumps is burned to reduce
the volume. This practice, according to the Florida Sanitary Code,
is illegal. Some dump operators burn over the solid waste material
before burying it in a sanitary landfill ; while this is an economical
step, it is not acceptable. Such burnings may contribute to air
pollution when carried out near populated areas. Some operators
don't cover the burned dumps.

Many of the counties and cities have programs of solid waste
pick-up and disposal. Some restrict the pick-up only to garbage
and do not pick up yard trash. But those counties and communities
which do not have any such system leave it up to their residents
to dispose of their solid wastes the best way they can. The only
way is to drop it somewhere, burn it or bury it. The latter method
is sanctioned by the State Board of Health, but it must be done
in an approved manner {as stated in the Florida Sanitary Code).

Sanitary Landfills

The best and most economical way for a small community to
properly dispose of its solid waste material is the sanitary land-
fill, but in Florida much of the land is too wet for such operations.
There are approximately 160 sanitary landfills in 40 Florida coun-
ties under the state arthropod control program. In addition, there

are many other sanitary landfill operations throughout Florida that
do not participate in the state program. However, not all of the
landfills are properly operated. The county, mosquito control dis-
trict or private firm which is to manage a sanitary landfill must
submit its plans to the County Health Department. These plans
must include a map showing the location and work plan of the
landfill. The State Board of Health reviews the plans, makes such
field investigations as it deems necessary, and either approves or
disapproves the proposed operation.

According to the Florida Sanitary Code, separate disposal areas
are necessary for rubbish, offal and dead animals and sewage sludge
from septic tanks. These areas are to be covered with six inches
of dirt or sand each day. No trench or pit in which wastes are to
be placed should have water in it during the filling operation but
it is most difficult to operate a landfill in an area where there is
a high water table. The Code further specifies that the site of the
landfill should have an all-weather road and be accessible by trucks
and cars. Garbage must be compacted in layers not more than six

In a sanitary landfill, a
bulldozer pushes trash
into a ditch into which
water has seeped (left).
A high water table is one
of the problems faced by
such operations in Flor-
ida. Another dump (right)
has been set on fire by
thoughtless people. This
is a violation of the Flor-
ida Sanitary Code.

FLORIDA HEALTH NOTES

The waste material in many open dumps is burned to reduce
the volume. This practice, according to the Florida Sanitary Code,
is illegal. Some dump operators burn over the solid waste material
before burying it in a sanitary landfill ; while this is an economical
step, it is not acceptable. Such burnings may contribute to air
pollution when carried out near populated areas. Some operators
don't cover the burned dumps.

Many of the counties and cities have programs of solid waste
pick-up and disposal. Some restrict the pick-up only to garbage
and do not pick up yard trash. But those counties and communities
which do not have any such system leave it up to their residents
to dispose of their solid wastes the best way they can. The only
way is to drop it somewhere, burn it or bury it. The latter method
is sanctioned by the State Board of Health, but it must be done
in an approved manner (as stated in the Florida Sanitary Code).

Sanitary Landfills

The best and most economical way for a small community to
properly dispose of its solid waste material is the sanitary land-
fill, but in Florida much of the land is too wet for such operations.
There are approximately 160 sanitary landfills in 40 Florida coun-
ties tinder the state arthropod control program. In addition, there

• "

.5T-«E

-■•*« >

are many other sanitary landfill operations throughout Florida that
do not participate in the state program. However, not all of the
landfills are properly operated. The county, mosquito control dis-
trict or private firm which is to manage a sanitary landfill must
submit its plans to the County Health Department. The.se plans
must include a map showing the location and work plan of the
landfill. The State Board of Health reviews the plans, makes such
field investigations as it deems necessary, and either approves or
disapproves the proposed operation.

According to the Florida Sanitary Code, separate disposal areas
are necessary for rubbish, offal and dead animals and sewage sludge
from septic tanks. These areas are to be covered with six inches
of dirt or sand each day. No trench or pit in which wastes are to
be placed should have water in it during the filling operation but
it is most difficult to operate a land fill in an area where there is
a high water table. The Code further specifies that the site of the
landfill should have an all-weather road and be accessible by trucks
and cars. Garbage must be compacted in layers not more than six

In a sanitary landfill, a
bulldozer pushes trash
into a ditch into which
water has seeped (left).
A high water table is one
of the problems faced by
such operations in Flor-
ida. Another dump I right l
has been set on fire by
thoughtless people. This
is g violation of the Flor-
ida Sanitary Code.

FLORIDA HEALTH NOTES • 339

feet in depth; it must be sufficiently covered with dirt to form a
closed cell at the end of each day's operation ; and when each cell
Is closed out, it must be covered with at least two feet of sand,
loam or other suitable material. Before the operation can be con-
sidered completed, the slopes must be seeded with grass; main-
tenance continued until the fill has stabilized. This is done to pre-
vent cracks in the fill, depressions and erosion of the surface and
side slopes.

The three methods of landfills are:

* the trench method in which each day's refuse is covered by
dirt excavated from an adjoining: trench;

* the ramp or progressive method, in which the covering ma-
terial is obtained from an area just ahead of the face of the dump;
and

* the area method, in which uneven or low areas are filled with
refuse and earth brought in from another location to cover the
refuse. This latter method may be carried out when the landfill
does not interfere with natural drainage.

Because of the high water tables and because land suitable for
sanitary landfills is expensive, governmental units have difficulty
in obtaining good land for this type of solid waste disposal. Many
times a community will take an option on a tract of land for a sani-

Solid Waste Sanitary Districts

Solid waste sanitary districts may be a future means of combating
the solid waste disposal problem. When the cost of such waste dis-
posal is prohibitive for a small county or municipality, two or more
neighboring counties or cities may band together to form a sanitary
district for this purpose. In such a district a centra My -located in-
cinerator would replace unsatisfactory landfills or dumps; the cost of
construction and operation would be divided among the participating
government units.

340 • FLORIDA HEALTH NOTES

tary landfill and people living in the area will make such strong
objections against the proposal that the option is dropped. This
has happened time and time again in many Florida cities. Borrow
pits and excavations sometimes contain water. These cannot be
used for depositing garbage but construction materials, trees, palm
fronds and other such materials are sometimes placed in them.

Disposal by Incineration

Where suitable land is available at a reasonable price, the
properly operated sanitary landfill is more economical on a short-
time basis than the incinerator. Currently there are 12 county or
municipally-owned incinerators in Florida although not all of them
are in operation.

As communities expand and population density increases, cen-
tral incineration for a metropolitan area can become a prime al-
ternate to the sanitary landfill, despite the high cost of construc-
tion and operation. An incinerator requires a small amount of land ;
it can be located near the refuse collection area, saving the cost of
hauling the refuse a great distance. The properly operated in-
cinerator can achieve a major reduction in volume of refuse, re-
ducing the organic portion to ashes which may be hauled to a
sanitary landfill. Incinerators are flexihle; operations can be ad-
justed to seasonal or daily variations.

There are disadvantages to incinerators. The cost of construc-
tion is high and a suitable staff to operate the incinerator is
difficult to obtain. A small number of communities in other states
have built incinerators that used all of their financial resources.
They then could not enlarge the plants to handle the increased
load of refuse resulting from expanding populations and at the
same time they had no capital to finance supplemental disposal
facilities.

Air pollution restrictions may require installation and main-
tenance of expensive control devices. Wet scrubbers, used to reduce
the fly ash emitted from the stacks of an incinerator, result in
steam. Many people, when they see such a plume, throw up their

FLORIDA HEALTH NOTES • 341

■■ ■■

hands and shout, "Pollution!" To offset this situation, electro-
static precipitators have been installed to remove the fly ash and
these have proved satisfactory but the initial cost is greater.

In most of the heavily populated Florida counties, where all
of the incinerators in the state are located, land suitable for sani-
tary landfills is high-priced real estate, and therefore incineration
is the answer to solid waste disposal. Most of these plants have
been built and operated successfully without air pollution or other
problems. The State Board of Health recognizes that a municipal
incinerator is a major factor in the future of solid waste dis-
posal.

Composting

Composting is a method of taking garbage and refuse, treating
them and turning out a finished product which can be applied to
the ground as a soil restorer. Composting is practiced extensively
in Europe but it is being discontinued due to the shortage of pu-
trescible material. The method has not been widely accepted in the
United States because there is no way to utilize the final product.
Chemical fertilizers can give far better results for the price but
compost may be used as a ground conditioner for forests and pas-
tures. At the present time there are only two small composting
plants in Florida.

342

FLORIDA HEALTH NOTES

■ -

. -OWNS M

Incineration is one of the best methods of
solid waste disposal. (Above, left to right)
The 450-ton, municipally-owned incinera-
tor at Fort Lauderdale is in full operation;
a compaction truck empties its load of
garbage into the pit at a Broward County
incinerator; an electric crane picks up a
pile of garbage from the pit and empties
it into the feeder which carries the waste
into the combustion chamber; a staff
member checks the control panel. Ashes,
tin cans and other wastes which would not
burn emerge from the furnace on an end-
less belt (right) and are emptied into a
truck. They are then hauled to a landfill
near the incinerator (below).

— «-

■■ It

hands and shout, "Pollution!" To offset this situation, electro-
static precipitators have been installed to remove the fly ash and
these have proved satisfactory but the initial cost is greater.

In most of the heavily populated Florida counties, where all
of the incinerators in the state are located, land suitable for sani-
tary landfills is high-priced real estate, and therefore incineration
is the answer to solid waste disposal. Most of these plants have
been built and operated successfully without air pollution or other
problems. The State Board of Health recognizes that a municipal
incinerator is a major factor in the future of solid waste dis-
posal.

Composting

Composting is a method of taking garbage and refuse, treating
them and turning out a finished product which can be applied to
the ground as a soil restorer. Composting is practiced extensively
in Europe but it is being discontinued due to the shortage of pu-
trescible material. The method has not been widely accepted in the
United States because there is no way to utilize the final product.
Chemical fertilizers can give far better results for the price but
compost may be used as a ground conditioner for forests and pas-
tures. At the present time there are only two small composting
plants in Florida.

342

FLORIDA HEALTH NOTES

Incineration is one of the best methods of
solid waste disposal. (Above, left to right)
The 450-ton, municipally-owned incinera-
tor ot Fort Lauderdale is in full operation;
a compaction truck empties its load of
garbage into the pit at a Broward County
incinerator; an electric crane picks up a
pile of garbage from the pit and empties
it into the feeder which carries the waste
into the combustion chamber; a staff
member checks the control panel. Ashes,
tin cans and other wastes which would not
burn emerge from the furnace on an end-
less belt (right) and are emptied into o
truck. They are then hauled to a landfill
near the incinerator (below).

The refuse is brought to the composting plant where the solid
waste is scanned and such materials as glass, coal, iron, nylon,
plastic, leather and rubber are removed. What remains is shredded
by one of several methods, including crushing or rasping. The
refuse is then allowed to decompose, a process in which disease-
carrying bacteria are reduced or killed by other forms of bacteria
and elevations in temperature. The moist organic matter in
the composting plant is disintegrated by the bacteria which needs
nitrogen for cell production. Fermentation is necessary because
if fresh refuse were put into the soil, the bacteria would deplete
the soil of nitrogen, an element which plant life needs to thrive.

Compost may be used in agriculture to restore poor and drought-
sensitive soils. These are primarily sandy and sandy loam soils,
the kinds we have in Florida. Not all plants reaet the same to com-
post but potatoes and turnips are examples of compost-loving crops.
In horticulture, compost is used on heavy soils. Good results have
been obtained with all kinds of vegetables, flower bulbs, fruit
trees, vineyards and citrus cultivation. Compost increases the water
absorbing capacity of the soil and can be used for playgrounds,
parks and, especially, athletic fields. However, the product cannot
be trusted because one never knows what's in it and it is too ex-
pensive to apply.

Salvaging Solid Wastes

One thing that could cut down on the amount of disposed solid
waste is the salvaging of some kinds of material.

The problem of solid waste disposal could be simplified to some
extent or reduced if salvaging and reclamation steps were taken
by municipal and private means. Salvage operations, which were
profitable a number of years ago, have largely been abandoned for
economic reasons, interference with normal disposal operations, or
because of nuisances the operations created.

New procedures for salvaging wastes are needed to replace
antiquated, costly and undesirable methods of scavenging, sorting
and hand picking. Because disposal costs are often financed from

344 • FLORIDA HEALTH NOTES

Such solid wastes as
wrecked and useless au-
tomobiles are used as fill
in a low marshy area.

general funds or lumped with other operations, many large pro-
ducers of wastes are not aware of the true cost of refuse dis-
posal. There is little or no incentive to reduce the quantity of
wastes or find new uses for waste material.

Examples of wastes and possible uses that could be explored

are:

* organic wastes made into animal feed, antibiotics, enzymes,
vitamins, or other pharmaceuticals and plastics;

* discarded tires and greases and oils from gasoline stations,
machine shops and similar places burned as fuel in special furnaces ;

* paper wastes used for wallboard, acoustical and insulating
materials, spray mulches, fertilizer and insecticide carriers ; and

* fly ash as additive to concrete or insulating materials, soil
stabilizer or carrier for fertilizers and insecticides.

Some wastes, such as abandoned automobiles, barnyard wastes
and citrus pulp are already being' salvaged for use in steel produc-
tion, agriculture land restorer and animal feed.

FLORIDA HEALTH NOTES

345

The refuse is brought to the composting plant where the solid
waste is scanned and such materials as glass, coal, iron, nylon,
plastic, leather and rubber are removed. What remains is shredded
by one of several methods, including crushing or rasping. The
refuse is then allowed to decompose, a process in which disease-
carrying bacteria are reduced or killed by other forms of bacteria
and elevations in temperature. The moist organic matter in
the composting plant is disintegrated by the bacteria which needs
nitrogen for cell production. Fermentation is necessary because
if fresh refuse were put into the soil, the bacteria would deplete
the soil of nitrogen, an element which plant life needs to thrive.

Compost may be used in agriculture to restore poor and drought-
sensitive soils. These are primarily sandy and sandy loam soils,
the kinds we have in Florida, Not all plants react the same to com-
post but potatoes and turnips are examples of compost-loving crops.
In horticulture, compost is used on heavy soils. Good results have
been obtained with all kinds of vegetables, flower bulbs, fruit
trees, vineyards and citrus cultivation. Compost increases the water
absorbing capacity of the soil and can be used for playgrounds,
parks and, especially, athletic fields. However, the product cannot
be trusted because one never knows what's in it and it is too ex-
pensive to apply.

Salvaging Solid Wastes

One thing that could cut down on the amount of disposed solid
waste is the salvaging of some kinds of material.

The problem of solid waste disposal could be simplified to some
extent or reduced if salvaging and reclamation steps were taken
by municipal and private means. Salvage operations, which were
profitable a number of years ago, have largely been abandoned for
economic reasons, interference with normal disposal operations, or
because of nuisances the operations created.

New procedures for salvaging wastes are needed to replace
antiquated, costly and undesirable methods of scavenging, sorting
and hand picking. Because disposal costs are often financed from

344 • FLORIDA HEALTH NOTES

„

3*5**-

Such solid wastes as
wrecked and useless au-
tomobiles are used as fill
in a low marshy area.

general funds or lumped with other operations, many large pro-
ducers of wastes are not aware of the true cost of refuse dis-
posal. There is little or no incentive to reduce the quantity of
wastes or find new uses for waste material.

Examples of wastes and possible uses that could be explored

are:

* organic wastes made into animal feed, antibiotics, enzymes,
vitamins, or other pharmaceuticals and plastics;

* discarded tires and greases and oils from gasoline stations,
machine shops and similar places burned as fuel in special furnaces;

* paper wastes used for wallboard, acoustical and insulating
materials, spray mulches, fertilizer and insecticide carriers ; and

* fly ash as additive to concrete or insulating materials, soil
stabilizer or carrier for fertilizers and insecticides.

Some wastes, such as abandoned automobiles, barnyard wastes
and citrus pulp are already being salvaged for use in steel produc-
tion, agriculture land restorer and animal feed.

FLORIDA HEALTH NOTES

345

Proper Home Refuse Storage and Disposal

We have tried to present a picture of the solid waste problem
as it exists in Florida and the United States. There is no simple
solution. Sweeping it behind the door won't work and private
citizens and public officials who try to ignore the problem find
that it keeps creeping out to embarrass them in complaints of un-
sightly landscapes and evil-smelling dumps.

But what can you do to help your community?
At home you can

* provide and use proper, water-tight containers to store gar-
bage and refuse,

* maintain the containers in a sanitary condition,

* drain and wrap garbage in newspapers and bundle bulky rub-
bish,

* place the containers in the right place at the proper time
for garbage pick-up,

* separate garbage, ashes and rubbish if required to do so by
the pick-up service,

* remove any trash from yard or attic each week and set it
out for collection, and

* support governmental agencies trying to provide proper col-
lection and disposal.

Also you should become acquainted with your solid waste dis-
posal service operation and know that your community is operating
a safe and sanitary landfill or incinerator. If there is an open
or burning dump in your community, find out how the situation can
be corrected through your local government. Proper handling and
disposal of solid wastes are necessary for a safe, comfortable home
and an attractive, healthful community.

346 • FLORIDA HEALTH NOTES

ftjWHDA STATE LIBRABY

Proper Home Refuse Storage and Disposal

We have tried to present a picture of the solid waste problem
as it exists in Florida and the United States. There is no simple
solution. Sweeping it behind the door won't work and private
citizens and public officials who try to ignore the problem find
that it keeps creeping out to embarrass them in complaints of un-
sightly landscapes and evil-smelling dumps.

But what can you do to help your community?

At home you can

* provide and use proper, water-tight containers to store gar-
bage and refuse,

* maintain the containers in a sanitary condition,

* drain and wrap garbage in newspapers and bundle bulky rub-
bish,

* place the containers in the right place at the proper time
for garbage pick-up,

* separate garbage, ashes and rubbish if required to do so by
the pick-up service,

* remove any trash from yard or attic each week and set it
out for collection, and

* support governmental agencies trying to provide proper col-
lection and disposal.

Also you should become acquainted with your solid waste dis-
posal service operation and know that your community is operating
a safe and sanitary landfill or incinerator. If there is an open
or burning dump in your community, find out how the situation can
be corrected through your local government. Proper handling and
disposal of solid wastes are necessary for a safe, comfortable home
and an attractive, healthful community.

346

FLORIDA HEALTH NOTES

F LORIDA

HEALTH
NOTES

*ft

vo jme 59— no. 10 ^j^awuo! Public Health
loc o.« m ...DadeCount?

The Dade County Department of Pub-
lic Health has had full responsibility
for the organizing, directing and coordi-
nating of the Cuban Refugee Health
Center which sees some 530 persons
each day.

<Jl Jnem,o\lai to _i. G. Cato

PUBLIC HEALTH
in DADE COUNTY

Dade County, Florida — where glittering hotels nudge each other
for miles along the sunny beaches and where the Gulf Stream
caresses the shore with a year 'round tenderness.

Dade County, Florida — where illiterate bands of migrants stoop
in the hot sun to pick vegetables and Miccosukees spear gar from
primitive canoes.

Dade County, Florida — where refugees from another country,
with another tongue and culture, swarm by the thousands, confused
and dispossessed, struggling to find new homes to replace those
wrested from them by a tyrant.

*******

This is the geographically-fragmented and ethnically -kaleido-
scopic area in which Turner Elam Cato, M.D., M.P.H., strove for 27
years to lead and guide the forces of public health, not only to
meet the needs of the present but to anticipate those of the future.

Dr. Cato, director of the Dade County Department of Public
Health since 1942, died July 8, 1967, and left behind him an effi-
cient, effective and far-reaching public health complex seldom seen
in the nation.

Vexation in Paradise

The attractions of Miami, Miami Beach and their municipal
neighbors need no description. They are well-known phenomena
of American and international fame. But this is modern history.

(Cover photo) The Miami city skyline is representative of metropolitan
Dade County which Dr. T. E. Cato served as director of the Dade County
Department of Public Health.

FLORIDA HEALTH NOTES • 351

The Dade County Department of Pub-
lic Health has had full responsibility
for the organizing, directing and coordi-
nating of the Cuban Refugee Health
Center which sees some 530 persons
each day.

Ji Juemp\iai to _i. O. Cato

PUBLIC HEALTH

in DADE COUNTY

Dade County, Florida — where glittering hotels nudge each other
for miles along the sunny beaches and where the Gulf Stream
caresses the shore with a year 'round tenderness.

Dade County, Florida — where illiterate bands of migrants stoop
in the hot sun to pick vegetables and Miccosukees spear gar from
primitive canoes,

Dade County, Florida — where refugees from another country,
with another tongue and culture, swarm by the thousands, confused
and dispossessed, struggling to find new homes to replace those
wrested from them by a tyrant.

*******

This is the geographically-fragmented and ethnically-kaleido-
scopic area in which Turner Elam Cato, M.D., M.P.H., strove for 27
years to lead and guide the forces of public health, not only to
meet the needs of the present but to anticipate those of the future.

Dr. Cato, dh-eetor of the Dade County Department of Public
Health since 1942, died July 8, 1967, and left behind him an effi-
cient, effective and far-reaching public health complex seldom seen

in the nation.

Vexation in Paradise

The attractions of Miami, Miami Beach and their municipal
neighbors need no description. They are well-known phenomena
of American and international fame. But this is modern history.

'Cover photo) The Miami city skyline is representative of metropolitan
Dade County which Dr. T. E. Cato served as director of the Dade County
Department of Public Health.

FLORIDA HEALTH NOTES • 351

Within the lifetime of people still able to remember, South Florida
was, according to a member of Congress, "an uninhabitable morass
of jungle and heat, snakes and mosquitoes, alligators and savage
Indians."

The Seminole wars had ended but the other hazards remained.
In the late 19th Century the only access was by sea. Key West
was the only city in South Florida and that was isolated on an
island a couple of hundred miles to the south. Miami, from may ami
(very big), was a trading post and mail drop with about a dozen
people. A few people had made unsuccessful ventures into fruit
and vegetable growing in the narrow strip of land between the
coast of the Everglades, but there was one man who was to come
and help change the destiny of South Florida.

Henry M. Flagler, developer of North and Central Florida and
railroad builder, was jolted in St. Augustine when the "great
freeze" of 1894 wiped out the citrus industry. Mrs. Julia Tuttle,
owner of most of the land that is now downtown Miami, sent him
a bouquet of orange blossoms and he started building his railroad
on to Miami. Later with colleagues John S. Collins, Carl F. Fisher,
Glenn Curtis and others, he poured money in staggering sums into
the development of the area. A chain reaction boom developed, and
in 1926 outlying inaccessible swampland was selling for $25,000 an
acre. The bubble burst ; the land went begging at $5 an acre ; but
today this same land has been filled and there are stores, homes,
schools and churches where a few decades ago there were man-
grove swamps.

The real estate crash of 1926 was followed by the depression of
1929, and this thwarted further expansion. The hurricane of 1935,
in which trainloads of Civil Conservation Corps workers were

FLORIDA HEALTH NOTES

Published monthly by the Floridct State Board of Health, Wilson T. Sowder, M.D., M.P.H,,
State Health Officer, Publication office. Box 210, Jacksonville, Florida 32201. Second class
postage paid at Jacksonville, Florida. This publication is for individuals and institutions with
on interest in the state's health programs. Permission Is given to quote any story providing
credit is given to the Florida State Board of Health. Editor: Robert A. Schoonover, M.A,,
Division of Health Education.

VOLUME 59 — NO. 10 OCTOBER 1«7

352 • FLORIDA HEALTH NOTES

washed into the sea and undiked Lake Okeechobee spread across
the land, took a terrible toll. Glades and salt marsh mosquitoes
were nuisances when the wind blew from the swamps. Hastily
planned sewers poured human waste in appalling volume into beau-
tiful Biscayne Bay.

Early Public Health Efforts

In 1904, when controls were available for yellow fever and
malaria, South Florida was affected by the fact that the United
States was starting to build the Panama Canal, Flagler was build-
ing his "impossible" railroad across the miles of shallow water to
Key West. Dr. J. Y. Porter, Florida's first health officer, and his
small staff were beating back public health hazards with brute
force tactics.

They were having success, too, for in 1907, Dr. Porter reported
that there was "not a single case" of contagious disease among the
thousands of workers who were employed by Flagler, and that the
"isolation hospital," established for their care, was standing empty
with its armed guard idling in the doorway. Dr. Porter went on
to praise the Flagler forces for taking complete responsibility for
the care of their own incapacitated, saying that it saved the state
and county the expense of caring for those who would have other-
wise become indigent. He was strong in his praise of the sanitary
engineering done by the railroad in its work camps, adding that
as a result there were no cases of typhoid fever.

In 1909, Dr. Porter reported an outbreak of 15 cases of typhoid
in the South Florida area but the incipient epidemic died out when
instructions were given to scald all milk and boil drinking water
from private wells. The year was called "a very successful one for
public health."

Beginning in the Midst of Crisis

Despite the depression of the 1930s, the vision of a warm, Flor-
ida beach in mid-winter was being held up to millions of Amer-
icans. As investors and visitors they came. Efforts to keep hotel
construction ahead of the demand were described as frantic. People

FLORIDA HEALTH NOTES

353

In 1922 Miami Beach's Collins Avenue was a narrow street set with palm
trees. Although the climate and sunshine were already present, the hotels
and apartment houses were yet to come. Compare this view with the one
of Collins Avenue today on page 360.

with no experience were pressed into service as kitchen help.
Flimsy, gaudily-painted shacks were thrown up to house carnival-
type businesses grasping for the tourist dollar. Pollution increased.
Giant rats abandoned ships in the harbor and found homes in the
rubbish heaps and shabby buildings. As a principal port-of -entry,
the area was in danger of being infected by persons coming from
South and Central America, Africa or Asia where pestilential
disease existed.

But in addition to the tourist, huckster and shill, there were
citizens willing and anxious to see that things were done right,
public health protected and modern agencies and facilities con-
structed for the purpose.

The stage for the formation of the Dade County Department
of Public Health was set in 1931 when the Florida Legislature
passed Florida Statute 154 which established the full-time local
health units "for the control and eradication of preventable diseases

354

FLORIDA HEALTH NOTES

and inculcate modern scientific methods of hygiene, sanitation,
and the prevention of communicable diseases."

In 1939, the Dade County Board of Commissioners said that it
could not find its way clear to establish a county health unit and
the $15,000 allotted for that purpose was stricken from the budget.

But in 1940, the Dade County heath unit was formed through
the efforts of County Commissioner Charles H. Crandon, members
of the Dade County Medical Association, and other civic leaders
with Dr. Cato as the health commissioner. At the time the cities
of Miami, Miami Beach, Coral Gables, plus 10 school districts, were
giving some health services to residents of the area. A survey of
public health and sanitation in the county was made in October
1941 under the direction of the U.S. Public Health Service and the
State Board of Health. It found that "health control and sanitation
in the Miami area . . . inadequate and not fitted to the present
needs." In the County Court House were two health departments,
one dealing solely with health matters applying to Miami and the
other concerned with the county program excluding Miami. The
City of Miami Beach maintained several nurses and a sanitary in-
spector working under a part-time county health officer. Coral
Gables had a full-time sanitary inspector and a nurse operating
independent of the county health unit.

When Dr. Cato arrived in Miami in 1940, the county had set
aside $7500 for the health unit. This amount was matched by
state and federal appropriations to be expended through the State
Board of Health. According to plans for the new unit, the duties
were to be divided into (1) the collection, classification, compilation
and analysis of vital statistics ; (2) education work in health and
hygiene; (3) management and control of communicable diseases;
(4) laboratory woi*k; and (5) sanitation.

One thing that the survey of 1941 recommended was a single
health authority for Dade County founded on state law to provide
stability. It also recommended that within two years the health
authority should be expanded to the size commensurate with a
population of 500,000 persons and that it should be provided with
plans for further expansion to meet increasing needs.

FLORIDA HEALTH NOTES

355

In 1922 Miami Beach's Collins Avenue was a narrow street set with palm
trees. Although the climate and sunshine were already present, the hotels
and apartment houses were yet to come. Compare this view with the one
of Collins Avenue today on page 360.

with no experience were pressed into service as kitchen help.
Flimsy, gaudily-painted shacks were thrown up to house carnival-
type businesses grasping for the tourist dollar. Pollution increased.
Giant rats abandoned ships in the harbor and found homes in the
rubbish heaps and shabby buildings. As a principal port-of -entry,
the area was in danger of being infected by persons coming from
South and Central America, Africa or Asia where pestilential
disease existed.

But in addition to the tourist, huckster and shill, there were
citizens willing and anxious to see that things were done right,
public health protected and modern agencies and facilities con-
structed for the purpose.

The stage for the formation of the Dade County Department
of Public Health was set in 1931 when the Florida Legislature
passed Florida Statute 154 which established the full-time local
health units "for the control and eradication of preventable diseases

354

FLORIDA HEALTH NOTES

and inculcate modem scientific methods of hygiene, sanitation,
and the prevention of communicable diseases."

In 1939, the Dade County Board of Commissioners said that it
could not find its way clear to establish a county health unit and
the $15,000 allotted for that purpose was stricken from the budget.

Bui in 1910, the Dade County heath unit was formed through
the efforts of County Commissioner Charles H. Crandon. meml>ers
of the Dade County Medical Association, and other civic leaders
with Dr. Cato as the health commissioner. At the time the cities
of Miami, Miami Beach. Coral Cables, plus 10 school districts, were
giving some health services to residents of the area, A survey of
public health and sanitation in the county was made in October
1941 under the direction of the U.S. Public Health Service and the
State Board of Health. It found that "health control and sanitation
in the Miami area . . . inadequate and not fitted to the present
needs." In the County Court House were two health departments,
one dealing solely with health matters applying to Miami and the
other concerned with the county program excluding Miami. The
City of Miami Beach maintained several nurses and a sanitary in-
spector working under a part-time county health officer. Coral
Gables had a full-time sanitary inspector and a nurse operating
independent of the county health unit.

When Dr. Cato arrived in Miami in 1940, the county had set
aside $7500 for the health unit. Th[s amount was matched by
state and federal appropriations to be expended through the State
Board of Health. According to plans for the new unit, the duties
were to lie divided into (1) the collection, classification, compilation
and analysis of vital statistics; (2) education work in health and
hygiene: (3) management and control of communicable diseases;
(4) laboratory work; and (5) sanitation.

One thing that the survey of 1941 recommended was a single
health authority for Dade County founded on state law to provide
stability. It also recommended that within two years the health
authority should be expanded to the size commensurate with a
population of 500,000 persons and that it should be provided with
plans for further expansion to meet increasing needs.

FLORIDA HEALTH NOTES • 355

Dr. Cato was well qualified for the position of County Health
Officer. He entered public health work on graduation from the Uni-
versity of Tennessee Medical School in 1928. He served one year as
health officer in Lamar County, Alabama; another year in a like posi-
tion in Gilmer County, West Virginia, and from 1931 to 1937, in a
similar post in Hancock County of the same stare.

In 1937, Dr. Cato became health officer of West Virginia's largest
county, Kanawha, where he was credited with the county's model
sanitary regulations for food handlers and dairies under county
supervision, and the establishment of modern venereal disease and
tuberculosis clinics. He became a leader in immunization work for
infants and mothers and the number of diphtheria and typhoid cases
dropped after his policies were put into effect.

* r f w •

Dade County Commissioner Crandon; A. W. Newitt, M.D.,
Director of the Bureau of Local Health Services of the State Board
of Health; A. B. Curry, city manager of Miami; and two officers
from the U. S. Public Health Service, Wilson T. Sowder and A. I.
Kernish, appeared before various city and county governmental
bodies to present the plans for a countywide health unit. (Dr.
Sowder became the State Health Officer for Florida in 1945 and
still holds that position; Dr. Kernish is a practicing physician in
Coral Gables.)

The municipalities and school board agreed to participate and
put up $148,000 requested which were augmented by state and
federal money. Plans were made to spend the money wisely and
according to Dr. Newitt with "no frills and no fancy quarters but
simply the kind of a health department that can dig in and do the
work and do a good job."

The duplication and overlapping, which is always observed
where separate health departments exist in an area the size of
Dade County, came to an end on November 10, 1942, with consoli-
dation of all the city health departments and the county health
unit into the Dade County Department of Public Health. A re-
tired U.S. Public Health Service officer, T. H. D. Griffitts, was
named the director and Dr. Cato was made assistant director. In

356

FLORIDA HEALTH NOTES

a few months, Dr. Griffitts resigned and Dr. Cato became county
health officer, a position he held until his death.

The consolidation was the first step toward the metropolitan
government which came into being in Dade County 15 years later.
This form of government was described as "the first attempt in
the country to establish a new type of overall political unit cover-
ing a complete metropolitan area."

The War Period

The proponents of consolidation were assisted by the facts
that World War Two had begun ; a number of military installations
with an estimated military population of 10,000 had moved into
Dade County, which had 312,000 persons; and there was a rising
need for supervision and control of environmental health. Nearly
every hotel in Miami Beach became a training school for Armed
Forces officers. The venereal disease rate in Florida was the worst
in the nation; 2.6 per cent of white men and 28.70 per cent of
Negro men examined for military service from Dade County had
syphillis.

The bars, restaurants and food stores frequented by servicemen
were checked by sanitarians but the rapid turnover of restaurant
employees necessitated the employment of untrained and inex-
perienced workers. There was difficulty in procuring metal gar-
bage cans and equipment. Food and drink establishments were
found to be reusing paper plates; a deliveryman was found carry-
ing unwrapped bread on a dirty and sweaty arm. Enforcement of
stringent sanitary laws improved the condition in Dade County
restaurants.

Available records show that typhus infection was most fre-
quently contracted in the business places or other congested areas
which were heavily infested with rats, and rodent control efforts
were confined to these areas of Dade County communities. Water
supplies were regularly checked but in some cases the recommended
changes could not be accomplished due to the shortage of plumbers
and war conditions. Shallow wells with pitcher pumps were dan-
gerously close to pit privies. Drainage wells, of which there were
at least 281 in Dade County, contributed to the pollution of under-
ground water. Out of 205 wells tested in 1943, 156 showed con-
tamination.

FLORIDA HEALTH NOTES • 357

Medical care for servicemen's wives and infants was financed
by the Children's Bureau but authorization for the service had to
come from the county health unit. Because the Army and Navy
Medical Corps had a number of trained obstetricians in Dade
County, the State Board of Health and Federal Government agreed
that servicemen's cases had to be handled by Army and Navy
physicians. When maternal and infant care was given to service
families, the work of the health unit's nursing service doubled in
one month.

The cost of operating the Dade County Department of Public
Health during the war year of 1944 was $238,000, of which
$170,900 came from local funds. The per capita cost was 54 cents,
far below the recommended per capita cost of one dollar. Including
special projects, the 1966 budget was nearly $5 million, of which
$1.3 million was from local funds and the per capita cost was $1.30.

The Post-War Period — Expansion

From 1945, Miami, Miami Beach and Dade County became
synonymous with "a spot in the sunshine." Through the efforts of
business and governmental agencies and the attraction of the sub-
tropical climate, tourists flocked to the area to sample the pleasures
of Florida. The strip from Miami northward to Palm Beach be-
came known as Florida's Gold Coast ; thousands of former service-
men, who had been delighted with the area during the war years,
came back in the post-war period to settle, start businesses and
raise their families.

Because these were people from other parts of the United States
who had been used to urban health services and sanitation con-
trol, the Dade County Department of Public Health developed new
programs to meet the demands. Because cities were being created
out of mangrove swamps and palmetto-covered fields, they had
no tradition on which to build.

The county health unit started with the basic public health pro-
grams of sanitation, maternal and child health, nursing, vital sta-
tistics and dental health, plus communicable disease, tuberculosis
and venereal disease control. To this was added a large number of
health services and programs over the next two decades. Divisions

358 • FLORIDA HEALTH NOTES

AUAMMMO

TURNER ELAM CATO, M.D., M.P.H.

Dade County, the State of Florida and organized medicine lost a
most valued friend when Dr. T. Elam Cato died in July, 1967.

A top-flight administrator of the Dade County Department of
Public Health, he was truly a Master of Public Health. Under his
leadership, the Department had become one of the finest in the United
States. Though understaffed constantly, he overcame the myriad prob-
lems with foresight, wisdom and resourcefulness.

We shall all miss his soft voice and guiding hand. We shall never
forget his leadership, his knowledge and his inborn humility. His
memorial stands in Miami on N. W. 14th Street which he built and
loved.

July 31, 1967

Jack Q. Cleveland, M.D., Chairman
Dade County Health Advisory Board
336 Alhambra Circle
Coral Gables, Florida 33134

of sanitary engineering, health education, mental health and re-
search were added; nutrition consultation services and social work
services were started and clinics for retarded children, premature
infants and child guidance were included. Within the past seven
years programs in air pollution control, health mobilization, hos-
pitals and nursing home inspection and licensure, adult health and
aging programs, chronic diseases, comprehensive health services for
children and youth, and maternity and infant care have been ap-
pended. Perhaps one of the biggest jobs given the Dade County
Department of Public Health was the Cuban Refugee Health Pro-
gram. More will be said later about this and some of the other more
outstanding programs. A laboratory was planned in the original
setup but this became a function of the State Board of Health's
chain of regional laboratories.

An example of how the health unit has grown is shown by the
way the staff has expanded to meet the needs of growing Dade

FLORIDA HEALTH NOTES

359

r v

£.<*-

»=

• ...

3 ^

h. *j

County. In 1945, the staff consisted of 92 persons, including three
physicians, 33 nurses, 23 sanitarians and 20 clerks. The 1966 staff
totaled over 600 persons, including approximately 45 physicians,
165 public health nurses, 57 sanitarians, 70 clerical personnel and
five sanitary engineers, plus employees in special programs and
other disciplines.

360

FLORIDA HEALTH NOTES

Dade County has a wide range of social groups — ranging from the inhabi-
tants of glamorous Miami Beach (opposite page) to the Miccosukees who
dwell in tharched-roof chickees along the Tamiami Trail.

Although the Dade County Department of Public Health fre-
quently has had financial difficulty, it still is one of the best
county health units in the nation. The expansion of the health
unit could not have been possible without the cooperation of
numerous organizations, schools, hospitals, voluntary health agen-
cies, governmental offices and individuals. From the days of 1944,
when the health department cooperated with the Army and Navy
by inspecting prenatal clinics at military installations, to the
present, with public health field experiences being provided nursing
students from Barry College, University of Miami School of Nurs-
ing, Miami-Dade Junior College, Jackson Memorial Hospital and
other institutions, the cooperation has always been on the highest
level.

Over the years the county health unit has cooperated :

• with the Florida State Board of Health, U.S. Public Health
Service, U. S. Children's Bureau and other state and governmental
agencies in a wide number of surveys, programs and projects;

• with the University of Miami School of Medicine, Jackson
Memorial Hospital, Dade County Medical Association and other

FLORIDA HEALTH NOTES

361

County. In 1945, the staff consisted of 92 persons, including three
physicians, 33 nurses, 23 sanitarians and 20 clerks. The 1966 staff
totaled over 600 persons, including approximately 45 physicians,
165 public health nurses, 57 sanitarians, 70 clerical personnel and
five sanitary engineers, plus employees in special programs and
other disciplines.

360

FLORIDA HEALTH NOTES

Dade County has a wide range of social groups — -ranging from the inhabi-
tants of glamorous Miami Beach (opposite page) to the Miccosukees who
dwell in thatched -roof chickees olong the Tamiami Trail.

Although the Dade County Department of Public Health fre-
quently has had financial difficulty, it still is one of the best
county health units in the nation. The expansion of the health
unit could not have been possible without the cooperation of
numerous organizations, schools, hospitals, voluntary health agen-
cies, governmental offices and individuals. From the days of 1944,
when the health department cooperated with the Army and Navy
by inspecting prenatal clinics at military installations, to the
present, with public health field experiences being provided nursing
students from Barry College, University of Miami School of Nurs-
ing, Miami-Dade Junior College, Jackson Memorial Hospital and
other institutions, the cooperation has always been on the highest
level.

Over the years the county health unit has cooperated :

• with the Florida State Board of Health, U.S. Public Health
Service, U. S. Children's Bureau and other state and governmental
agencies in a wide number of surveys, programs and projects;

• with the University of Miami School of Medicine, Jackson
Memorial Hospital, Dade County Medical Association and other

FLORIDA HEALTH NOTES

361

With Hie possmg of Dr. T. E. Giro, public health lost one of its
best administrators and many of us lost a staunch and valued friend.

I have known Elam for many years and have admired and respected
his abilities as a leader in the public health field. His warm and
friendly manner contributed to a pleasant association, both on the
occasion of professional visits and during social functions.

His sincerity, untiring devotion to duty, and wise leadership has
contributed to the success of the program in every position that he has
so ably occupied, and particularly in his role* as Director of the Dade
County Department of Public Health.

No finer monument could be erected to this man than the
realization that he devoted his life to the betterment of mankind.

I consider myself fortunate to have known him and to be numbered
among his friends who are grieved of his passing.

Hugh B. Cottrell, M.D.

Medical Director

U.S. Public Health Service

►

J

organizations in such programs as the Premature Demonstration
Center, Child Development Center, Diagnostic Hearing Clinic,
Maternal and Infant Care Project and Anti-Convulsive Clinics;

• with Jackson Memorial and Mt. Sinai Hospitals in poison
control centers;

• with the Dade County Tuberculosis Association in x-ray
screening programs;

• with the Dade County Board of Public Instruction in the
mental hygiene clinic ;

FLORIDA HEALTH NOTES

• with the Dade County Civil Defense in implementing 1 the
civil defense progTam ;

• with the University of Florida, Family Service Agency, Dade
County Department of Welfare, Juvenile Court and Dade County
Board of Public Instruction in the Child Guidance Clinics;

• with the Vocational, Technical and Adult Education Division
of the Dade County Schools in the training of practical nurses,
dental technicians and other paramedical personnel; and

• with many other organizations and agencies in educational and
health service programs too numerous to mention.

Over the years since 1942 a number of problems were faced
by Dr. Cato and his staff. Many of these problems continue today
while others were met and conquered. One of these latter was
poliomyelitis, which was eradicated through great immunization
campaigns. In 1957, Salk vaccine injections were given to nearly
300,000 persons. However, polio persisted and in 1960 over 413,000
Dade County residents under 40 years of age were given one-dose
Cox oral vaccine in one of the largest field trials ever organized.

Public health nurses carry on one of the biggest continuing pro-
grams which keeps expanding. Today a total of 96 clinic sessions
is held weekly in the eight health centers. Over the years they
have examined children in schools with the assistance of volunteers
from the Parent-Teacher Association; supervised midwives when
they were numerous; visited homes of accident patients to help
prevent repetition of such accidents ; given home nursing service to
persons with chronic diseases or long-term illnesses ; and instructed
new mothers in the care of infants. The Visiting Nurse Associa-
tion, founded in Dade County in 1946, continues today as a part of
the public health program with the head of the health depart-
ment's nursing division as director. The Association was certified
in 1966 as a Home Health Agency under Medicare.

Continuing projects in clinics and public education emanates
from the Venereal Disease Control Program. Public health nurses

FLORIDA HEALTH NOTES • 363

ll»t I Ut. l_\_/0 I UUL. I W 1 !%*■ I ■

■t.

Elom Cat© was a wonderful human being,
a gentleman, and an outstanding public
health physician. He was well trained in
public health, and had considerable experi-
ence elsewhere, before he became the Health
Officer of the then recently consolidated
countywide health department in Dade
County. He made excellent use of his train-
ing and experience. These assets plus his
intelligence, honesty, courage, forth Tightness,
and persistence all contributed to the de-
velopment and maintenance of one of the
finest local health departments in the nation.
This health department reflected Dr. Cato's
devotion to duty and his progressiveness.
It kept up with the times. His programs not
only included all of the traditional aspects
of public health but developed practically all
of the newer ones which have come to the
fore during the past two decades. He wove
the new and the traditional, including such
unique programs as comprehensive health
care for the Cuban refugees into a coordi-
nated and highly effective partem of county -
wide health services which commanded the

Dr. T, ]

respect of every segf
and his colleagues els
in the nation. His I
never maintained in

make home visits to patients and assist the special venereal disease
investigators who enlist the help of physicians, private laboratories
and hospitals in detecting- syphilis, gonorrhea and other venereal
diseases and sending people to the clinic for treatment.

From the beginning the Dade County Department of Public
Health's sanitarians have inspected food and drink establishments,
dairies and milk distributors, slaughterhouses, swimming pools,
septic tanks and labor camps. As the health unit was expanded,
child day care centers, hospitals and nursing homes, convalescent
homes, mobile home parks, schools and airport sanitation became
additional programs for inspection. In an effort to secure better

364

FLORIDA HEALTH NOTES

■^*^---»** 'j

lam Cato

rent of the community

where in Hie state and

coith department was

isolation from other

local, state and federal agencies, but always
functioned in the fullest spirit of cooperation.
He developed unusually close ties with the
medical school and always worked closely
with the State Board of Health in the state
wide public health programs. Through these
and many other activities he and his programs
played an ever increasing and vital role in
the total national effort in the field of health.
His personal life and public career repre-
sents a glowing example of one man's dedi-
cation and contribution to humanity of which
Dade County, the State of Florida; and the
entire nation can be proud. It is because of
his outstanding accomplishments that the
Florida State Board of Health pays him the
unique tribute of dedicating to his memory
this entire issue of its monthly publication
of Health Notes.

Wilson T. Sowder, M.D., M.P.H
Florida State Health Officer

sanitation procedures in food and drink establishments, food han-
dlers schools have been in operation since 1944.

Hurricanes, which threaten Florida, along with other areas in
the summer months, are feared less today because of advance
warnings from the U.S. Weather Bureau. However, such storms
when they occur, bring floods — with the possibility of typhoid from
polluted drinking water — and interruption of electricity, with the
failure of refrigerators and resulting food spoilage. Sanitarians
condemn huge amounts of spoiled foods and check private wells;
public health nurses conduct typhoid immunization clinics in
cooperation with the American Red Cross.

FLORIDA HEALTH NOTES

365

■

The Cuban Influx

The year 1959 saw the rise of the Castro government in Cuba
and the beginning of the waves of refugees who were seeking
asylum from the Communist regime. The United States opened
its doors to any Cuban of goodwill who wanted to come to this
country seeking democracy, freedom and peace. Because Dade
County was the nearest point to the island, it received the impact
of the migration. Over a quarter of a million Cubans have arrived
since 1961. Many of the refugees settled in the Dade County area
with the hope of soon returning to their homeland. Others have

366 • FLORIDA HEALTH NOTES

The airport sanitation pro-
gram of the Dade County
Department of Public Health
is a leader in its field. The
sanitarian in charge of the
program supervises such
activities as the cleaning of
planes (opposite page) and
the servicing of aircraft
toilet systems, in addition
to food service and water
supply.

been relocated in other cities, such as New York, Chicago, Los
Angeles, New Orleans and Tampa.

Dade County, Florida and the United States recognized their
responsibilities and started action which led to the Cuban Refugee
Relief Program and the health services. The Dade County De-
partment of Public Health had full responsibility for organizing,
directing and coordinating the medical services for the refugees.

At the clinics held in Freedom Tower (former home of the
Miami News) the Cubans receive medical screening of all new ar-
rivals, immuni2ations, chest x-rays, provisions for medical diagnosis
and treatment for those who are indigent, referral to local com-
munity facilities for those services not available at the clinics,
referrals to health department clinics (well-baby, maternity, vene-
real disease, etc.) and provisions for emergency dental services.
Out of the 125,000 Cubans in the Dade County area, an average of

FLORIDA HEALTH NOTES

367

The Cuban Influx

The year 1959 saw the rise of the Castro prove in merit in Cuba
and the beginning of the waves of refugees who were seeking
asylum from the Communist regime. The United States opened
its doors to any Cuban of goodwill who wanted In come to this
country seeking democracy, freedom and peace. Because Dade
County was the nearest point to the island, it received the impact
of the migration. Over a quarter of a million Cubans have arrived
since 1961. Many of the refugees settled in the Dade County area
with the hope of soon returning to their homeland. Others have

366

FLORIDA HEALTH NOTES

The airport sanitation pro-
gram of the Dade County
Deportment of Public Health
is a leader in its field. The
sanitarian in charge of the
program supervises such
activities as the cleaning of
planes (opposite page* and
the servicing of aircraft
toilet systems, in addition
to food service and water
supply.

been relocated in other cities, such as New York, Chicago, Los
Angeles, New Orleans and Tampa.

Dade County, Florida and the United States recognized their
responsibilities and started action which led to the Cuban Refugee
Relief Program and the health services. The Dade County De-
partment of Public Health had full responsibility for organizing,
directing and coordinating the medical services for the refugees.

At the clinics held in Freedom Tower (former home of the
Miami News) the Cubans receive medical screening of all new ar-
rivals, immunizations, chest x-rays, provisions for medical diagnosis
and treatment for those who are indigent, referral to local com-
munity facilities for those services not available at the clinics,
referrals to health department clinics (well -baby, maternity, vene-
real disease, etc.) and provisions for emergency dental sei vices.
Out of the 125,000 Cubans in the Dade County area, an average of

FLORIDA HEALTH NOTES

367

As head of Florida's largest county health deportment, Dr. T. E.
Caro responded to the challenge of providing health services of high
quality. His leadership was progressive. Of particular interest are the
programs he established for mothers and children and for Cuban
refugees. He early saw the need for a maternity and infant care proj-
ect and family planning service for the Miami area, and enlisted
community support as well for the children and youth project in order
to give Dade County a well-rounded program of services to mother
and children.

Arthur J. Lesser, M.D., Deputy Chief
Children's Bureau

U.S. Department of Health, Education,
and Welfare

•••••■•

530 persons is seen daily at the Cuban Refugee Center, which has
a well-organized medical staff, nurses, x-ray laboratory, clerical
personnel and pharmacy.

Over 875 Cubans still arrive weekly in the two-planes-a-day
airlift from Cuba. These persons are examined at another clinic at
the Miami International Airport where they are given chest x-rays
and immunization. Those who are awaiting the arrival of relatives
or are holding reservations to other cities stay at Freedom House
which is operated by the Cuban Refugee Program. Here they re-
ceive food, clothing, rooms for sleeping and medical services, if
needed.

Outstanding Dade County Programs

Dr. Cato's administration of the Dade County Department of
Public Health was an outstanding example of the application of
countywide public health services. Following are some of the im-

368

FLORIDA HEALTH NOTES

portant programs and projects which were developed in Dade
County.

The Premature Demonstration Center provides not only for the
care of premature infants and the training of nurses but conducts
research into the saving of lives of such babies and carries on
studies to help prevent premature births. Ten years ago the
premature rate at the Center was 20 per cent of all births. Today,
through programs of maternity care, better nutrition and family
planning, the rate has been cut to 12 per cent and the death rate
of premature babies has been cut from 17 to 12 per cent.

The Child Development Center was originally started as a clinic
where a child suspected of being mentally retarded could be evalu-
ated and diagnosed. In recent years, the emphasis has been changed
to include the training of professional personnel and the giving of
consultative services. Research has been carried on in genetics,
cytology, phenylketonuria and other causes of mental retardation.

The Reservation Indian Health Care Program deals with some
180 Miecosukees who live along the Tamiami Trail and is financed
entirely with federal funds. A multiphasic screening program in
1963 showed that the health of the Indians was far below that of
other county residents. Now in cooperation with the Bureau of
Indian Affairs, they are provided with physician office visits ; den-
tal services ; fees for laboratory, prosthetics, drugs and physician's
services; and hospitalization.

Migrant health had always been a concern of Dr. Cato and his
staff. From the beginning, the improvement of migrant labor
camps was an uphill battle. While some camp operators were most
cooperative, the conditions of other camps were so bad that inves-
tigators were horrified and camp owners were told to correct sani-
tary conditions or be taken to court. Stricter regulations were
instituted and all migrant camps now are required to meet these
standards in order to obtain licenses to house workers. A number
of clinics are held in migrant camps and provide much needed med-
ical and dental care for hundreds of migrants who had no other
access to these resources.

FLORIDA HEALTH NOTES • 369

The Maternal and Infant Care Project carries some 5000
mothers and children under one year of age on its records. An
average of 2800 maternal and 1200 pediatric visits are made to
homes of patients by the public health nurses during a week, and
25 clinics are conducted in seven health centers. All maternity
patients are given comprehensive medical care; those who have
high risk pregnancies (in which there are complications) are given
hospitalization and total care. Nearly 90 per cent of the post-
partum patients return for family planning and examinations. The
women are encouraged to space their children and limit the number
to those they can care for.

Research was one part of the Dade County Department of Public
Health in which Dr. Cato took a big interest. The research section,
organized in 1957, was one of the first of its kind in the South-
eastern United States, and its progress was followed by the na-
tion's public health officials. Working with the State Board of

Children play in the
diagnostic playroom of
the Child Development
Center, one of the
cooperative programs
carried on by the Dade
County Department of
Public Health, Univer-
sity of Miami School
of Medicine, Jackson
Memorial Hospital and
other organizations
and institutions.

Health, University of Miami School of Medicine, National Institutes
of Health and other governmental agencies, the Dade County De-
partment of Welfare and other county health groups, the research
section has carried on a number of outstanding studies. A few of
these are: epidemiologic study of nursing home residents; in-
vestigation of syphilis deaths in Dade County; epidemiologic in-
vestigation of accidents involving sliding glass doors; determina-
tion of prenatal hemoglobin levels as related to age, trimester and
parity; and the evaluation of neurological and sensory disease
problems in Dade County.

Rodent Control has been important in the Dade County De-
partment of Public Health since its inception. Typhus was a
problem for a number of years. Attempts were made to eradicate
rats with red squill "torpedoes" scattered in such places as busi-
ness districts, parks and the banks of the Miami River and canals.
Rut the rats weren't killed and typhus persisted. After World War
Two, DDT was available and the health unit used it lavishly
wherever rats ran. The fleas were killed but the rats are still
around. Warfarin is used for general purposes but where the
sanitarians have complete control (no people or pets) an extremely
effective rat poison, 1018, is used. Instructions on rat-proofing
buildings are given out and areas are cleared of trash to eliminate
rodent harborage.

The Airport Sanitation program carried on by the Dade County
Department of Public Health at the Miami International Airport is
a leader in its field. The airport complex handles a total of seven
million passengers a year. The sanitarian in charge of this program
oversees such facilities as in-flight catering kitchens, food service
establishments and sanitary facilities in the airport buildings, and
sanitary sewage disposal of wastes from aircraft.

The Health Assessment Program is a pilot project carried on
under contract with the U.S. Department of Health, Education and
Welfare and the State Board of Health at the Miami Beach Health
Center. Permanent residents of Dade County who are over 66 years

FLORIDA HEALTH NOTES • 371

■

The Maternal and Infant Care Project carries some 5000
mothers and children under one year of ape on its records. An
average of 2800 maternal and 1200 pediatric visits are made to
homes of patients by the public health nurses during a week, and
25 clinics are conducted in seven health centers. All maternity
patients are given comprehensive medical care; those who have
high risk pregnancies (in which there are complications) are given
hospitalization and total care. Nearly 90 per cent of the post-
partum patients return for family planning and examinations. The
women are encouraged to space their children and limit the number
to those they can care for.

Research was one part of the Dade County Department of Public
Health in which Dr. Cato took a big interest. The research section,
organized in 1957, was one of the first of its kind in the South-
eastern United States, and its progress was followed by the na-
tion's public health officials. Working with the State Board of

Children play in the
diagnostic playroom of
the Child Development
Center, one of the
cooperative programs
carried on by the Dade
County Department of
Public Health, Univer-
sity of Miami School
of Medicine, Jackson
Memorial Hospital and
other organizations
and institutions.

Health, University of Miami School of Medicine, National Institutes
of Health and other governmental agencies, the Dade County De-
partment of Welfare and other county health groups, the research
section has carried on a number of outstanding studies, A few of
these are: epidemiologic study of nursing home residents; in-
vestigation of syphilis deaths in Dade County; epidemiologic in-
vestigation of accidents involving sliding glass doors; determina-
tion of prenatal hemoglobin levels as related to age, trimester and
parity; and the evaluation of neurological and sensory disease
problems in Dade County,

Rodent Control has been important in the Dade County De-
partment of Public Health since its inception. Typhus was a
problem for a number of years. Attempts were made to eradicate
rats with red squill "torpedoes" scattered in such places as busi-
ness districts, parks and the banks of the Miami River and canals.
But the rats weren't killed and typhus persisted. After World War
Two, DDT was available and the health unit used it lavishly
wherever rats ran. The fleas were killed but the rats are still
around. Warfarin is used for general purposes but where the
sanitarians have complete control {no people or pets) an extremely
effective rat poison, 1018, is used. Instructions on rat-proofing
buildings are given out and areas are cleared of trash to eliminate
rodent harborage.

The Airport Sanitation program carried on by the Dade County
Department of Public Health at the Miami International Airport is
a leader in its field. The airport complex handles a total of seven
million passengers a year. The sanitarian in charge of this program
oversees such facilities as in-flight catering kitchens, food service
establishments and sanitary facilities in the airport buildings, and
sanitary sewage disposal of wastes from aircraft.

The Health Assessment Program is a pilot project carried on
under contract with the U.S. Department of Health, Education and
Welfare and the State Board of Health at the Miami Beach Health
Center. Permanent residents of Dade County who are over 65 years

FLORIDA HEALTH NOTES • 371

and medically indigent are given a limited physical examination
which includes chest x-ray, blood sugar, hemoglobin, electrocardio-
gram and cytology. Their height and weight are also measured.
Out of 919 persons seen between December 1966 and July 1967,
165 persons were new diabetics and 54 with glaucoma were re-
ferred to physicians. Eighty-four persons were referred to hos-
pitals and 245 persons sent to physicians for further study and
treatment.

The Community Studies in Pesticides were started because of
the national concern regarding pesticides and the 13 deaths in Dade
County in 1963 which were attributed to pesticides. The county was
chosen because of the climate, the agriculture carried on in the
western portion of the county and the amount of pesticides used.
Since the program began, over 80 poisonings due to organophos-
phate pesticides have been investigated, and 114 persons are re-
ceiving monthly blood and urine tests for general health documen-
tation under an occupational health program.

Pollution Control has been an important program in this resort
city. In 1947 Philip Wylie published a magazine article, "Florida —
Polluted Paradise," in which he said that Biscayne Bay was "the

372

FLORIDA HEALTH NOTES

color of mildew," that "ebb tide carries some of its polluted water
out in front of Miami Beach twice daily," and that a number of
sewers belched forth sewage into the azure pride of the twin
cities, Other writers have jumped on the same bandwagon, in-
cluding authors of a book with the same title.

A survey conducted by the State Board of Health in 1949 bore
out Wylie's charges. Conditions were such that unless steps were
taken there would be further threats to public health which would
have an adverse effect upon the economic, aesthetic, recreational
and commercial interests of the metropolitan area.

The Dade County Department of Public Health and Miami took
firm action to clean up Biscay ne Bay. Intercepter lines, totaling 16
miles in length, were built along the shore and the Miami River,
picking up sewage that was being emptied into the blue waters.
These lines were connected to a force main which was run under

Thousands of acres of
South Dade County
are devoted to agricul-
ture (opposite page).
The health and living
conditions of migrants
(such as the one at
right) who work in the
fields are major con-
cerns of the State
Board of Health and
the Dade County De-
partment of Public
Health.

Jp$J^

and medically indigent are given a limited physical examination
which includes chest x-ray, blood sugar, hemoglobin, electrocardio-
gram and cytology. Their height and weight are also measured.
Out of 919 persons seen between Deeeml>er 1966 and July 1967,
165 persons were new diabetics and 54 with glaucoma were re-
ferred to physicians. Eighty-four persons were referred to hos-
pitals and 245 persons sent to physicians for further study and
treatment.

The Community Studies in Pesticides were started because of
the national concern regarding pesticides and the 13 deaths in Dade
County in 1963 which were attributed to pesticides. The county was
chosen because of the climate, the agriculture carried on in the
western portion of the county and the amount of pesticides used.
Since the program began, over 80 poisonings due to organophos-
phate pesticides have been investigated, and 114 persons are re-
ceiving monthly blood and urine tests for general health documen-
tation under an occupational health program.

Pollution Control has been an important program in this resort
city. In 1947 Philip Wylie pu Wished a magazine article, "Florida —
Polluted Paradise," in which he said that Biscayne Bay was "the

372

FLORIDA HEALTH NOTES

«

color of mildew," that "ebb tide carries some of its polluted water
out in front of Miami Beach twice daily," and that a number of
sewers belched forth sewage into the azure pride of the twin
cities. Other writers have jumped on the same bandwagon, in-
cluding authors of a book with the same title.

A survey conducted by the State Board of Health in 1949 bore
out Wylie's charges. Conditions were such that unless steps were
taken there would be further threats to public health which would
have an adverse effect upon the economic, aesthetic, recreational
and commercial interests of the metropolitan area.

The Dade County Department of Public Health and Miami took
firm action to clean up Biscay ne Bay. Intercepter lines, totaling 16
miles in length, were built along the shore and the Miami River,
picking up sewage that was being emptied into the blue waters.
These lines were connected to a force main which was run under

Thousands of acres of
South Dade County
are devoted to agricul-
ture (opposite page).
The health and living
conditions of migrants
I such as the one at
right) who work in the
fields are major con-
cerns of the State
Board of Health and
the Dade County De-
partment of Public
Health.

the bay to a treatment plant on Virginia Key. When this plant
went into operation, it could handle 47 million gallons of sewage a
day. Expansion can bring the capacity up to 153 million gallons,
sufficient to handle a population of 460,000 persons.

Today there are more than 90 sewage treatment plants serving
more than 47 per cent of the population. The remainder are served
by septic tanks but there is a continual campaign to bring sewerage
systems to more of the people. The existing plants serve motels,
subdevelopments, industrial plants, institutions and municipalities.
Biscayne Bay in 1967 is again a recreational playground.

Miami's air is about 50 per cent cleaner than that of most other
American cities of comparable size. Two main reasons for this
are the absence of heavy industry with accompanying smoke and
dust, and prevailing easterly winds which bring pure freshly-washed
air from the moderating Gulf Stream and the Atlantic Ocean,
However, the Air Pollution Control Division of the Dade County
Department of Public Health has laid the foundation for air quality
management programs to combat such problems as burning of
automobiles and commercial barbecues.

The Dade County Health Advisory Board

The Health Advisory Board was formed at the beginning of
the consolidated health department to set policies for the Dade
County Department of Public Health but it carried no administra-
tive function. Charles H. Crandon, the County Commissioner who
fought successfully for the health department, served as the
Board's first chairman. Problems facing the Board at its first
meeting were rat infestation, sanitation in restaurants, the large
number of persons receiving treatment for venereal disease, and
the shortage of nurses.

During the span of the next 25 years, the Board dealt with
such problems as inadequate hospital space, garbage collections, fly
and rodent control, sewage disposal, fluoridation, migrant camps
and health certificates. Dr, Cato had various members of his
staff give reports at the Board's meetings. One problem that con-

374 • FLORIDA HEALTH NOTES

tinued for years was the bringing of services to the people, and
health centers were planned for various sections of Dade County.
Likewise the Board participated in the planning of the Dade-Miami
Civic Center in which the public health central headquarters was
one of the first buildings erected. Since 1958, other buildings were
constructed which house the police academy, county jail, public
safety, judicial department, medical centers, hospitals and local
offices of state agencies.

The Dade County Department of Public Health ran smoothly
under the administration of Dr. Cato and the Health Advisory
Board. There was noted in the minutes of a meeting in 1946 that
there had been no interference from the Dade County Board of
Commissioners because of the smooth operation. Besides Mr.
Crandon, other men who served as chairmen were: County Com-
missioners Preston B. Bird, Jesse H. Yarborough and Ralph A.
Fossey; Tra F. Williard; Dewey R. Dedrick; and Dr. Jack Q.
Cleveland, who is current chairman and also president-elect of the
Florida Medical Association.

Dr. Cato - Physician, Administrator, Civic Leader

What sort of man was T. E. Cato in the minds of those who
followed his leadership, some of them for the full 27 years of his
Dade County career?

MM

— -,

Public Health on a Personal Basis

The story of Dade County Department of Public Health isn't one
told in cold statistics of so many births, deaths, chest x-rays, water
samples taken, restaurants inspected, children vaccinated, sanitary
surveys conducted. These figures are important in showing dangers
to personal health, problems eliminated and new menaces develop-
ing. To Dr. Cato and his aides, the important part of their work was
the day-to-day contact with individuals who make up the general public
and how they eventually wound up in reports as statistics.

"Good health must be on a personal basis," Dr. Cato said one time.
"Certainly it is a personal thing to the person involved. We try to
make the individual feel his case is extremely important. It is to him.
It is to us."

■ S . » ».^^~,

' W W ^f -r ■ w ■w-w- -^-

FLORIDA HEALTH NOTES

375

"He made you feel important," said one of his staff. "He was
easy to talk to, and wanted to help you solve your problems. He was
— well, available, that is if you could find him. He wasn't a desk
man."

"He visited all the clinics and project locations regularly," said
another. "He kept his finger on every detail of everything. He
delegated responsibility but he knew everything that was going on."

"He used persuasion to try to get you to accept his point of
view. But if that didn't work, he just told you — do it. He was one
of the strongest personalities I've ever met," said another of his
associates.

But as one of his closest colleagues summed it up, "He was the
power. He called for results and he got them. If you deserved a
compliment, you got it — and vice versa."

In his citation for the Meritorious Service Award of the Florida
Public Health Association in 1962, it is stated that his standing
among his medical colleagues in public health, professional educa-
tion and private practice might well be assessed in the fact that at
his insistence, along with that of others, a Department of Preven-
tive Medicine and Public Health was established at the University
of Miami School of Medicine.

The selection of Miami as the site for the final field trial of
Cox oral polio vaccine can be attributed in great part to the
reputation and high standing of Dr. Cato and his agency. He was
an active, respected and in some instances an office-holding-mem-
ber of nine professional associations, including his local, state and
national medical associations. The staff of the Cuban Emergency
Medical Dispensary gave him a plaque in recognition of his efforts
in their behalf.

One of the major contributions made by Dr. Cato to the future
of public health administration in Dade County was his effort to
decentralize the distribution of public health services — to bring
services closer to the people. According to R. Ray Goode, budget

376 • FLORIDA HEALTH NOTES

Not too many years ago the Miami River (foreground) and Biscayne Boy
(background) were the dumping grounds for some 70 sewer outfalls. Sewer-
age systems today are connected to an enormous treatment plant on Vir-
ginia Key and the bay is again a recreational playground.

director in the office of the manager of the metropolitan govern-
ment in Dade County, Dr. Cato's desire was to bring public health
services into every school and region of the county. Since the
1940s he preached a sermon that was to become the basic philosophy
of the "War on Poverty" in the mid-1960s: indigent individuals
and families will not avail themselves of medical and health services
if the services are inaccessible due to transportation difficulties.
Poor people often cannot, and more often will not, seek preventive
services without easy access and adequate public health education.
Unless both items (accessibility and public health education) are
present, the people most in need of preventive medical care will
forego such care until an emergency arises requiring hospitaliza-
tion. By then it is often too late, and death or crippling diseases
and unproductive lives result.

FLORIDA HEALTH NOTES

377

1

"He made you feel important," said one of his staff. "He was
easy to talk to, and wanted to help you solve your problems. He was
— well, available, that is if you could find him. He wasn't a desk

"He visited all the clinics and project locations regularly," said
another. "He kept his finger on every detail of everything. He
delegated responsibility but he knew everything that was going on."

"He used persuasion to try to get you to accept his point of
view. But if that didn't work, he just told you — do it. He was one
of the strongest personalities I've ever met," said another of his
associates.

But as one of his closest colleagues summed it up, "He was the
power. He called for results and he got them. If you deserved a
compliment, you got it — and vice versa."

In his citation for the Meritorious Service Award of the Florida
Public Health Association in 1962, it is stated that his standing
among his medical colleagues in public health, professional educa-
tion and private practice might well be assessed in the fact that at
his insistence, along with that of others, a Department of Preven-
tive Medicine and Public Health was established at the University
of Miami School of Medicine.

The selection of Miami as the site for the final field trial of
Cox oral polio vaccine can be attributed in great part to the
reputation and high standing of Dr. Cato and his agency. He was
an active, respected and in some instances an office-holding-mem-
ber of nine professional associations, including his local, state and
national medical associations. The staff of the Cuban Emergency
Medical Dispensary gave him a plaque in recognition of his efforts
in their behalf.

One of the major contributions made by Dr. Cato to the future
of public health administration in Dade County was his effort to
decentralize the distribution of public health services — to bring
services closer to the people. According to R. Ray Goode, budget

376 • FLORIDA HEALTH NOTES

Not too many years ago the Miami River (foreground) and Biscayne Say
background! were the dumping grounds for some 70 sewer outfalls. Sewer-
age systems today are connected to an enormous treatment plant on Vir-
ginia Key and the bay is again a recreational playground.

director in the office of the manager of the metropolitan govern-
ment in Dade County, Dr. Cato's desire was to bring public health
services into every school and region of the county. Since the
1940s he preached a sermon that was to become the basic philosophy
of the "War on Poverty" in the mid-1960s: indigent individuals
and families will not avail themselves of medical and health services
if the services are inaccessible due to transportation difficulties.
Poor people often cannot, and more often will not, seek preventive
services without easy access and adequate public health education.
Unless both items {accessibility and public health education) are
present, the people most in need of preventive medical care will
forego such care until an emergency arises requiring hospitaliza-
tion. By then it is often too late, and death or crippling diseases
and unproductive lives result.

FLORIDA HEALTH NOTES

377

By the time of Dr. Cato's death, public health clinics had been
established all over Dade County and plans were nearly completed
for one of his long-sought climes in the Cutler Ridge area of South
Dade, The Cutler Ridge project involved a goal long desired by
Dr. Cato — the concept of multi-service centers on an area- wide
basis. He realized the importance of having hospital emergency
room and diagnostic facilities on the same site with the regular
health clinic. Through his efforts, and those of other county of-
ficials, this project was approved as a joint Public Health-De-
partment of Hospitals operation. A similar project is being planned
for North Dade.

A Mission Well-done

It would be brash indeed for Florida Health Notes to point out
didactically that other county health departments could well profit
from the example set by the man and the organization we have had
under review. The Dade County Department of Public Health is
nationally recognized. It is known to have tackled and brought to
bay over the years many routine, and many unique problems. It is
known to have gained and held public esteem to the point that its
annual reports do not reflect any significant struggle for fiscal
sustenance.

It is known to have followed consistently the policy of taking
needed services to the people, time and location-wise, rather than
calling the people to a central, and often inconvenient place. It is
known to have looked upon its mission as being a part of a whole,
and to have led in the movement to bring together in action and
effectiveness many agencies, disciplines and interests for the bene-
fit of the overall program,

Dade County is most fortunate, and Florida is grateful in
having had the leadership, strength and foresightedness shown by
this public health organization. In years to come Dade County,
Florida, will surely continue to lead, to pioneer and to accomplish
great things in public health.

Illustrations: Cover and pages 360 and 377 courtesy of Miami-Metro News
Bureau; pages 354, 372 and 373, Florida News Bureau.

378 • FLORIDA HEALTH NOTES

FLORIDA

HEALTH
NOTES

voi JME 59-no 1 1 Food fh0la bora tory

NC EMBER 1967 a "^ YOU

FLORIDA STATE LIBRARY,

By the time of Dr. Cato's death, public health clinics had been
established all over Dade County and plans were nearly completed
for one of his long-sought clinics in the Cutler Ridge area of South
Dade. The Cutler Ridge project involved a goal long desired by
Dr. Cato — the concept of multi -service centers on an area- wide
basis. He realized the importance of having hospital emergency
room and diagnostic facilities on the same site with the regular
health clinic. Through his efforts, and those of other county of-
ficials, this project was approved as a joint Public Health-De-
partment of Hospitals operation. A similar project is being planned
for North Dade.

A Mission Well-done

It would be brash indeed for Florida Health Notes to point out
didactically that other county health departments could well profit
from the example set by the man and the organization we have had
under review. The Datle County Department of Public Health is
nationally recognized. It is known to have tackled and brought to
bay over the years many routine, and many unique problems. It is
known to have gained and held public esteem to the point that its
annual reports do not reflect any significant struggle for fiscal
sustenance.

It is known to have followed consistently the policy of taking
needed services to the people, time and location-wise, rather than
calling the people to a central, and often inconvenient place. It is
known to have looked upon its mission as being a part of a whole,
and to have led in the movement to bring together in action and
effectiveness many agencies, disciplines and interests for the bene-
fit of the overall program.

Dade County is most fortunate, and Florida is grateful in
having had the leadership, strength and foresightedness shown by
this public health organization. In years to come Dade County,
Florida, will surely continue to lead, to pioneer and to accomplish
great things in public health.

Illustrations: Cover and pages 360 and 377 courtesy of Miami-Metro News
Bureau; pages 354, 372 and 373, Florida News Bureau.

378 • FLORIDA HEALTH NOTES

F LORIDA

HEALTH
NOTES

^ ^

vo. jme 59-no 11 Food the La borarory

N C EMBER 1967 °nd YOU

FLORIDA Si ATE UBHAiiX

-

►

in a State Board of Health laboratory, tech-
nicians check in milk samples for testing
(top), count the bacteria in a milk specimen
(above) and prepare specimens for butter
fat testing (right).

FOOD,

the Laboratory

and YOU

HE Quiet Service — the competent, efficient, behind-the-
scenes, and sometimes seemingly miraculous processes
that go on in the State Board of Health's laboratories —
plays a vital part in keeping Florida's citizens and its visitors in
good health.

The laboratories — and those skilled persons who work in and
with them — are in closer daily touch with the public than you
might suspect. What goes on inside those walls of white, around
those racks of glass, between refrigerators and containers of stain-
less steel, under powerful microscopes, and in test tubes is often
the means of keeping you and your family healthy, of discovering
as quickly as possible what may have made you ill and thus pre-
venting its spread to other persons.

Most people eat three times a day. Many eat one or more meals
a day in one of Florida's 20,360 eating or drinking establish-
ments. Much of the meats and seafoods comes from 146 abattoirs
and 167 shellfish and Crustacea processing plants in the state. The
housewife buys her food from one or more of the state's 7384
grocery and meat markets. There are over 1280 other types of food
handling and processing establishments. Thus, there are countless
chances in the long sequence of many persons handling food in
various places for hostile organisms — animal and vegetable — to
creep in and cause illness. But because of the vigilance of the
personnel in State Board of Health laboratories in Jacksonville,
Miami, Tampa, West Palm Beach, Orlando, Tallahassee and Pen-
sacola; and county laboratories in Brevard and Pinellas; and that
of sanitarians who work out of County Health Departments, the
number of illnesses due to mishandling of food is remarkably small.

'Cover photo 1 A family dinner is usually without incident, but should food
poisoning occur, the State Board of Health laboratories are ready to help
find the cause of the disease and prevent its spread.

FLORIDA HEALTH NOTES

383

In a State Board of Health laboratory, tech-
nicians check in milk samples for testing
(top), count the bacteria in a milk specimen
labove> ond prepare specimens for butter
fat testing (right).

FOOD,

the Laboratory

and YOU

IUi m|HE Quiet Service — the competent, efficient, behind-the-
Kl Hi scenes, and sometimes seemingly miraculous processes
fQj Q3 that go on in the State Board of Health's laboratories —
plays a vital part in keeping Florida's citizens and its visitors in
good health.

The laboratories — and those skilled persons who work in and
with them — are in closer daily touch with the public than you
might suspect. What goes on inside those walls of white, around
those racks of glass, between refrigerators and containers of stain-
less steel, under powerful microscopes, and in test tubes is often
the means of keeping you and your family healthy, of discovering
as quickly as possible what may have made you ill and thus pre-
venting its spread to other persons.

Most people eat three times a day. Many eat one or more meals
a day in one of Florida's 20,360 eating or drinking establish-
ments. Much of the meats and seafoods comes from 146 abattoirs
and 167 shellfish and Crustacea processing plants in the state. The
housewife buys her food from one or more of the state's 7384
grocery and meat markets. There are over 1280 other types of food
handling and processing establishments. Thus, there are countless
chances in the long sequence of many persons handling food in
various places for hostile organisms — animal and vegetable — to
creep in and cause illness. But because of the vigilance of the
personnel in State Board of Health laboratories in Jacksonville,
Miami, Tampa, West Palm Beach, Orlando, Tallahassee and Pen-
sacola; and county laboratories in Brevard and Pinellas; and that
of sanitarians who work out of County Health Departments, the
number of illnesses due to mishandling of food is remarkably small.

(Cover photo) A family dinner is usually without incident, but should food
poisoning occur, the State Board of Health laboratories are ready to help
find the cause of the disease and prevent its spread.

FLORIDA HEALTH NOTES

383

I

There were only 1500 reported cases of food poisoning and
salmonellosis (a type of intestinal illness caused by a particular
kind of bacteria) in the state last year. Considering the state's
population of nearly six million, the number of meals served, the
millions of persons engaged in handling and preparing foods — in
the home, restaurants, community suppers and processing plants —
1500 is a relatively small figure. But this number of cases, if they
involved most communicable diseases, would be considered an
epidemic. However, the 1500 cases indicate the effectiveness of the
work of the public health laboratories.

Most people never see the kitchen of the restaurant or hotel
where they eat. Only a very few persons have had the privilege
of being in a laboratory or knowing what goes on there. This
issue of Florida Health Notes will try to tell you a little about
the Quiet Service — the State Board of Health laboratories which
are dedicated to helping to keep all of us well. Something will also
be said about the work of the sanitarian and epidemiologist in food
hygiene, the various bacteria which can make you sick, food in-
fections and intoxications and how to prevent food poisoning.

Responsibilities and Cooperation

Us

HE State Board of Health laboratory system was esta-
blished in 1916 in one room, operated by a woman for the
purpose of assisting physicians in diagnosing infectious
diseases and testing drinking water. Now, as many as 1.4 million
specimens a year are examined in the seven state and two county
public health laboratories.

The laboratories have a number of responsibilities, foremost of
which is the surveillance of food and continuing the original pur-
pose of determining the cause of illness. In addition to routine
diagnostic services for physicians, assistance is given to County
Health Departments in the investigation of outbreaks of disease.

FLORIDA HEALTH NOTES

Published monthly by the Florida State Board of Health, Wilson T. Sawder, M D , M.P.H.,
State Health Officer, Publication office. Box 210, Jacksonville, Florida 32201. Second class
postage paid at Jacksonville, Florida. This publication is for individuals and institutions with
an interest in the state's health programs. Permission is given to quote any story providing
credit is given to the Florida State Board of Health. Editor: Robert A, Schoonover, M.A-,
Division of Health Education.

VOLUME 59 — NO. tl NOVEMBER 1967

384 • FLORIDA HEALTH NOTES

Food poisoning outbreaks are primarily the concern of the County
Health Departments, the Division of Sanitation, the Bureau of Pre-
ventable Diseases and the laboratory receiving the specimens.

There is much cooperation between the state and county govern-
mental agencies to make sure that food is pure. County Health
Department personnel are responsible for investigating, collecting
and submitting proper specimens for testing. They are assisted by
State Board of Health consultants during serious outbreaks of food
poisoning. Adulteration or chemical contamination of food is the
responsibility of the Florida Department of Agriculture, which also
collects samples of shellfish and other foods from grocery stores
and sends them to State Board of Health laboratories which test
them for bacteriological purity. The Bureau of Sanitary Engineer-
ing of the State Board of Health approves shellfish waters (or puts
polluted waters off limits) while the State Department of Conser-
vation polices the area. However, oysters may be bootlegged and
even you might pick some unknowingly from a polluted area. This
can bring disease like typhoid, hepatitis or any of the enteric viruses
and bacteria harbored in man's intestinal tract.

How Food Poisoning Can Start

| HAT exactly does the County Health Department and State
Board of Health staff members do when a case of food
poisoning arises ? Let's take a look at a real life example.

One spring day recently, three student nurses at a Florida
hospital were taken ill and diagnosed by physicians as having
Shigellosis, a food-borne disease caused by the man-carried bacteria,
Shigella. Because the hospital feared publicity, it did not inform
the County Health Department and State Board of Health of these
three cases of food poisoning, and took upon itself the efforts to
find the cause of the infections.

The hospital submitted stool specimens from over 100 food
service workers to the State Board of Health regional laboratory
with no mention that these specimens were associated with a food
poisoning outbreak suspected of being Shigella. When no disease
is suspected, the laboratory routinely tests specimens from food
service workers by a procedure which is intended to pick up
typhoid bacteria. This was not the test the hopsital was expecting
and therefore no Shigella was found. When the results were re-

FLORIDA HEALTH NOTES

385

turned as "no typhoid bacteria indicated," the hospital adminis-
tration and medical staff accepted these reports as meaning that
there was no Shigella bacteria present and the source remained
undetected.

Six weeks later, 17 student nurses and two x-ray technician stu-
dents reported to the hospital emergency room with complaints
of diarrhea. All were diagnosed as having Shigellosis and at this
point the County Health Department and State Board of Health
were notified. An epidemiologist was called in to head the in-
vestigation conducted by the County Health Department staff
members.

Since student nurses were encouraged to report illnesses, and
possibly because it meant exclusion from classes and ward duty,
they were the first to report the infection. Minor illnesses, such as
mild diarrhea, were largely ignored by the employees of the hospi-
tal because it would have meant loss of time on the job and less pay.

Questioning of the hospital family (student nurses, employees,
housekeeping staff and non-nursing students) revealed the em-
ployees' cafeteria as the place where all of the sick persons had
eaten. The testing of stool specimens by the regional laboratory

386

FLORIDA HEALTH NOTES

;

In order to prevent con-
taminated food from reaching
the market, health agencies
and agricultural departments
keep close tabs on dairy food
production through the ino-
culating and examining of
dairy cows against disease, ex-
amining of dairy workers, sup-
ervising the processes of
bottling, and handling of milk
on the way to the food stores
and homes.

showed that 77 persons had Shigella infection. The search for the
common source of the infection revealed that the food for the
hospital patients and staff was prepared in the same kitchen yet
the patients suffered no attacks of Shigella. Somewhere between
the kitchen and the serving line of the employees' cafeteria was
the source of the infection.

Several violations of accepted food handling practices were
noted: including "glass dipping" of ice, open containers of mayon-
naise and other salad dressings in a self-service arrangement,
houseflies in the food preparation area, inadequate handwashing

FLORIDA HEALTH NOTES

387

turned as "no typhoid bacteria indicated," the hospital adminis-
tration and medical staff accepted these reports as meaning that
there was no Shigella bacteria present and the source remained
undetected.

Six weeks later, 17 student nurses and two x-ray technician stu-
dents reported to the hospital emergency room with complaints
of diarrhea. All were diagnosed as having Shigellosis and at this
point the County Health Department and State Board of Health
were notified. An epidemiologist was called in to head the in-
vestigation conducted l>v the County Health Department staff
members.

Since student nurses were encouraged to report illnesses, and
possibly because it meant exclusion from classes and ward duty,
they were the first to report the infection. Minor illnesses, such as
mild diarrhea, were largely ignored by the employees of the hospi-
tal because it would have meant loss of time on the job and less pay.

Questioning of the hospital family (student nurses, employees,
housekeeping staff and non-nursing students) revealed the em-
ployees' cafeteria as the place where all of the sick persons had
eaten. The testing of stool specimens by the regional laboratory

386

FLORIDA HEALTH NOTES

1 1

Jl\\

In order to prevent con-
taminated food from reaching
the market, health agencies
and agricultural departments
keep close tabs on dairy food
production through the ino-
culating and examining of
dairy cows against disease, ex-
amining of dairy workers, sup-
ervising the processes of
bottling, and handling of milk
on the way to the food stores
and homes.

showed that 77 persons had Shigella infection. The search for the
common sou ire of the infection revealed that the food for the
hospital patients and staff was prepared in the same kitchen yet
the patients suffered no attacks of Shigella. Somewhere between
the kitchen and the serving line of the employees' cafeteria was
the source of the infection.

Several violations of accepted food handling practices were
noted: including "glass dipping" of ice, open containers of mayon-
naise and otlu'i- salad dressings in a self-service arrai cement.
houseflies in the food preparation area, inadequate handwashing

FLORIDA HEALTH NOTES

387

facilities (fecal contamination of food was discovered twice during
the investigation), miscellaneous traffic through the kitchens, and
open garbage disposal containers.

In the final analysis, the employees' cafeteria was designated
as the probable place where the infections took place and tuna
and/or egg salad as the food involved — although samples of the
food were not available at the time the investigation started.

In retrospect, the first three cases of Shigella should have been
a signal of danger ahead for the hospital administration but, it
failed to recognize the presence of the pathogenic bacteria in the
hospital staff. If it had asked the regional laboratory for tests for
Shigella on the first group of stool specimens, the latter epidemic
may have been avoided. Also, the impulse of food service workers,
as well as nurses and other employees, to work despite attacks of
diarrhea had a tendency toward spreading the bacteria.

The Sanitarian

E^^jjOME restaurants seem to work on the theory that what
R^jn^i - vou don't see can't hurt you. The County Health Depart-
SS3SM ment sanitarians work on the idea that a clean dining
room is hardly any good if the kitchen is dirty — or if dirt is
brought in from outside. Some restaurants have been found to
keep screen doors open, letting in swarms of flies which have been
breeding outside. Some restaurants have parking lots in the rear
with entrance doors and passageways too close to exposed food.
The sanitarian checks

• the supply, storage and protection of foods;

f

* * - ■

Wilson T. Sowder, M.D., Florida's State Health Officer, soys "It is
obvious that for the protection of the health of Floridions and our
visitors, the State Board of Health and County Health Departments
must have the highest caliber and best trained personnel to make in-
spections of eating places and food-handling establishments to protect
the health of the public and prevent food-borne diseases.

'To this end, the Board now hires sanitarians with at least a
college degree. And provisions are made to send exceptional employees
to recognized schools of public health for graduate training. Highly
qualified personnel in every County Health Deportment receive con-
tinuing in-service training in all aspects of sanitation."

FLORIDA HEALTH NOTES

• all food handling" practices;

• the premises for mice, rats, ants, roaches and flies;

• the floors for cleanliness;

• all utensils to see that they are clean;

• all pesticides or insecticides to see that they are not stored
with food supplies ;

• the employees and their cleanliness — hands and clothing;

• the restrooms to determine whether there is enough soap
and towels;

• the disposal of sewage;

• the method of garbage disposal, water supply and cold
storage; and

• the hot water to see if it is hot enough and whether
utensils and dishes are sanitized.

The sanitarian also takes swab specimens of glasses, dishes and
utensils to test for the amount of bacteria which indicate how
well the items have been sanitizd.

County Health Departments often review plans for new restau-
rants in addition to checking plans for renovation. This can save
restaurant owners a lot of worry, trouble and expense and most
welcome this help.

Surveillance of Food Products

The Florida Legislature passed a law this year requiring that
all milk sold to the public be pasteurized. Before this, some 10,000
to 15,000 gallons of raw milk were sold each day, leaving the
drinkers subject to such diseases as bovine tuberculosis — to which
man is very susceptible; brucellosis (undulant fever) ; salmonellosis ;
various streptococcal infections, such as strep throat; and leptos-
pirosis, a bacterial disease. But due to constant surveillance by
health agencies, the Florida and the U. S. Departments of Agricul-
ture, a dairy is rarely so contaminated that it has to be closed.

Now through required pasteurization, these possibilities are
removed but there is still the chance that milk may be infected by
man. Here is where the laboratory's surveillance and testing play
a most important part in detecting the infectious diseases and
isolating their causes.

From each of the approximately 550 dairies in Florida, the
State Board of Health and County Health Department sanitarians

FLORIDA HEALTH NOTES

389

pick up one or more samples every month of each product the
dairies process or manufacture. These samples are kept under
constant refrigeration from the dairy to the laboratory, and may
reach only a maximum of 50 degrees Farenheit in the truck. Over
150,000 dairy samples are tested annually.

In the laboratory, the product is registered and a two-plate
bacteriological count is made. This means that a portion of the
product is diluted 1 -to- 100 and, in case a great deal of bacteria is
found, another portion is diluted l-to-1000. These samples are
placed on a petri dish containing agar, a gelatin product, and put
into an incubator where the bacteria are allowed to grow.

After 48 hours, the petri dishes are then taken out of the
incubator for a bacteria count. If no bacteria are found, the milk
(if that is what is being examined) is suspected of having some-
thing added to it to kill the bacteria. The laboratory technician ex-
pects to find less than 3000 bacteria per milliliter. (A milliliter is
1/1000 of a liter and a liter is approximately a quart.) If the count
runs over 30,000, the sanitarian looks for unsatisfactory conditions
in milk processing.

In testing solid foods other than milk, such as custard pie or a
sandwich, the specimen is placed in a blender with sterile water
and converted into a liquid, A two-plate count is run but this
time different types of bacteria are looked for and a different
growth medium — food in which each type of bacteria will grow —
is used. The staphylococcus count, a test for an organism which
does not cause illness unless there is an excessive number of
bacteria per milliliter present, indicates the food was contaminated

i — ■

Classes for Food Service Workers

| EARLY 50,000 Florida food service workers have been taught
the fine points of keeping food clean, fresh and attractive
in County Health Department programs. Students are given
general knowledge of how bacteria live, grow and cause disease. They
are shown how food can become contaminated by microscopic bac-
teria — or by such things as rats, insects or just plain dirt. The
keeping of utensils and hands clean is stressed. The students are also
taught the importance of good personal hygiene.

390

FLORIDA HEALTH NOTES

The County Health Deportment sanitarian takes a swab test of a glass in a
restaurant. This swob will be sent to a State Board of Health laboratory
where it will be tested for bacteria to see how well the glassware has been
sanitized.

by persons who had passed on the bacteria through infected cuts,
drippy noses or dirty hands.

A coliform count (another test for bacteria) indicates con-
tamination from organisms found in the intestines of man or
animal and a large number may mean dirty ingredients, hands
or equipment or too little refrigeration.

The tests will give evidence of three things:

• how clean and pure was the food;

• the condition under which it was produced ; and

• the hygiene of the workers.

If there had been a food-poisoning epidemic and sanitarians
were fortunate enough to obtain remnants of the suspected foods,
they are put through the same tests as the sandwich or pie taken
from a food-processing plant for periodic examinations. If the
sanitarians have no food available for testing, they must depend
upon analysis of stool or vomitus specimens from the victims.

FLORIDA HEALTH NOTES

391

pick up one or more samples every month of each product the
dairies process or manufacture. These samples are kept under
constant refrigeration from the dairy to the laboratory, and may
reach only a maximum of 50 degrees Farenheit in the truck. Over
150,000 dairy samples are tested annually.

In the laboratory, the product is registered and a two-plate
bacteriological count ia made. This means that a portion of the
product is diluted I-to-100 and, in case a great deal of bacteria is
found, another portion is diluted l-to-1000. These samples are
placed on a petri dish containing agar, a gelatin product, and put
into an incubator where the bacteria are allowed to grow.

After 48 hours, the petri dishes are then taken out of the
incubator for a bacteria count. If no bacteria are found, the milk
(if that is what is being examined) is suspected of having some-
thing added to it to kill the bacteria. The laboratory technician ex-
pects to find less than 3000 bacteria per milliliter. (A milliliter is
1/1000 of a liter and a liter is approximately a quart.) If the count
runs over 30,000, the sanitarian looks for unsatisfactory conditions
in milk processing.

In testing solid foods other than milk, such as custard pie or a
sandwich, the specimen is placed in a blender with sterile water
and converted into a liquid. A two-plate count is run but this
time different types of bacteria are looked for and a different
growth medium — food in which each type of bacteria will grow —
is used. The staphylococcus count, a test for an organism which
does not cause illness unless there is an excessive number of
bacteria per milliliter present, indicates the food was contaminated

Classes for Food Service Workers

EARLY 50,000 Florida food service workers have been taught
the fine points of keeping food clean, fresh and attractive
in County Health Department programs. Students are given
general knowledge of how bacteria live, grow and cause disease. They
are shown how food can become contaminated by microscopic bac-
teria — or by such things as rats, insects or just plain dirt. The
keeping of utensils and hands cleon is stressed. The students are also
taught the importance of good personal hygiene.

390

FLORIDA HEALTH NOTES

The County Health Deportment sanitarian takes a swab test of a glass in a
restaurant. This swab will be sent to a State Board of Health laboratory
where it will be tested for bacteria to see how well the glassware has been
sanitized.

by persons who had passed on the bacteria through infected cuts,
drippy noses or dirty hands.

A col if or m count (another test for bacteria) indicates con-
tamination from organisms found in the intestines of man or
animal and a large number may mean dirty ingredients, hands
or equipment or too little refrigeration.

The tests will give evidence of three things:

• how clean and pure was the food;

• the condition under which it was produced; and

• the hygiene of the workers.

If there had been a food-poisoning epidemic and sanitarians
were fortunate enough to obtain remnants of the suspected foods,
they are put through the same tests as the sandwich or pie taken
from a food-processing plant for periodic examinations. If the
sanitarians have no food available for testing, they must depend
upon analysis of stool or vomitus specimens from the victims.

FLORIDA HEALTH NOTES

391

A sanitarian (left)
takes a sample of
foods from a cooking
pot on a restaurant
stove. This sample
will be sent to the
laboratories to be
tested for bacteria.
Another sanitarian
(opposite page)
checks the cleanliness
of a restaurant's
deep fat fryer and
other equipment.

Taken during the acute stage of the disease, these specimens must
be put on a culture medium as quickly as possible because certain
forms of bacteria, such as Shigella, may decrease rapidly in num-
ber. Stool and urine specimens must be collected in a special bottle
containing a preservative solution to protect the bacteria during
shipment, and while they are being prepared for culture and
microscopic examination.

The initial period during which the pathogenic bacteria are
incubated (grow) takes 16 to 18 hours. Three to seven days are
required to complete the tests, depending on which bacterium is
found. Numerous media have been developed for isolation and
identification, and more recently complex media have been de-
veloped which are highly selective, greatly improving chances for
successful tests.

No single culture medium can be used for all the different types
of disease-causing bacteria which may be found; and the techni-
cians must be constantly alert because organisms do not necessarily
keep their typical shape. For example, Shigella and Salmonella
usually produce typical growth colonies (large numbers of bacteria
growing on another medium) but their appearances may be altered
when grown close to other organisms. Therefore, the greatest
care must be taken in sampling colonies if pure cultures are to be
obtained.

392

FLORIDA HEALTH NOTES

You may be interested — or perhaps alarmed — that acute
Shigella can kill in two or three days if left untreated. Usually
Salmonella may make you slightly ill for a few days, or it may
develop into a long-range affair. People who have lowered resistance
because of diabetes, hardening of the arteries, other diseases, or
who are taking cortisone, may develop into carriers of these
bacteria.

Four Organisms Which Will Make You Sick

Salmonella, one of the most common causes of
food poisoning, is a rod-shaped bacterium. It
is carried largely by domestic animals, chiefly
poultry and pigs, but humans carry it also. It
is transmitted by contamination from feces
and contact with uncooked meats and poultry-
Over 800 different types are known. PREVEN-
TION: Thorough cooking of foods and keep-
ing hot foods hot and cold foods cold; good
personal hygiene ; proper sewage treatment and
purification of water supply.

d\

A sanitarian (left)
takes a sample of
foods from a cooking
pot on a restaurant
stove. This sample
will be sent to the
laboratories to be
tested for bacteria.
Another sanitarian
(opposite page)
checks thecleanliness
of a restaurant's
deep fat fryer and
other equipment.

Taken during the acute stage of the disease, these specimens must
be put on a culture medium as quickly as possible because certain
forms of bacteria, such as Shigella, may decrease rapidly in num-
ber. Stool and urine specimens must be collected in a special bottle
containing a preservative solution to protect the bacteria during
shipment, and while they are being prepared for culture and
microscopic examination.

The initial period during which the pathogenic bacteria are
incubated (grow) takes 16 to 18 hours. Three to seven days are
required to complete the tests, depending on which bacterium is
found. Numerous media have been developed for isolation and
identification, and more recently complex media have been de-
veloped which are highly selective, greatly improving chances for
successful tests.

No single culture medium can be used for all the different types
of disease-causing bacteria which may be found ; and the techni-
cians must be constantly alert because organisms do not necessarily
keep their typical shape. For example, Shigella and Salmonella
usually produce typical growth colonies (large numbers of bacteria
growing on another medium) but their appearances may be altered
when grown close to other organisms. Therefore, the greatest
care must be taken in sampling colonies if pure cultures are to be
obtained.

392

FLORIDA HEALTH NOTES

You may be interested — or perhaps alarmed — that acute
Shigella can kill in two or three days if left untreated. Usually
Salmonella may make you slightly ill for a few days, or it may
develop into a long-range affair. People who have lowered resistance
because of diabetes, hardening of the arteries, other diseases, or
who are taking cortisone, may develop into carriers of these
bacteria.

Four Organisms Which Will Make You Sick

Salmonella, one of the most common causes of
food poisoning, is a rod-shaped bacterium. It
is carried largely by domestic animals, chiefly
poultry and pigs, but humans carry it also. It
is transmitted by contamination from feces
and contact with uncooked meats and poultry.
Over 800 different types are known. PREVEN-
TION: Thorough cooking of foods and keep-
ing hot foods hot and cold foods cold; good
personal hygiene; proper sewage treatment and
purification of water supply.

Shigella is also a rod-shaped bacterium which
is sometimes found in the military under field
conditions and in institutions housing many
people in close conditions. Some 37 types of
the bacteria are recognized. Man is the reser-
voir and the bacteria are spread by contamina-
tion from infected persons and failure to wash
hands after using the toilet. PREVENTION:
Thorough cooking of foods, good personal hy-
giene, fly control, proper sewage treatment and
purification of water supply.

Staphylococcus is a spherical organism which
appeal's in bunches (like grapes). In growing,
these organisms produce a potent toxin (poison)
which when consumed will result in severe ill-
ness. Man is the prime source and a person with
a draining sinus or open, infected wound is to be
suspected. Personal contact spreads it — phys-
ically touching or airborne oral or nasal dis-
charge. PREVENTION: Immaculate personal
hygiene; avoid common use of toilet articles;
stay away from coughers and sneezers.

Clostridium botulinum is the cause of botulism
and, like staphylococcus, produces a potent toxin
which when ingested causes severe illness and
death. The organism is rod-shaped with
squared-off ends. The illness is characterized
by weakness, dizziness, headache, constipation
and paralysis of the nerves. Hoarseness is often
the first sign. The reservoir is soil and intest-
inal tract of animals, including fish. In chick-
ens, the bacterium causes a paralytic infection
called "limberneck." In contrast to other bac-
teria, C. botulinum can withstand boiling temperatures but the
toxin, which makes one sick, is easily killed. Contaminated foods
are the immediate cause of illness. PREVENTION : Proper can-
ning procedures, including home and industrial processing; boiling
home-canned vegetables and cooking home-canned meats at least 15
minutes with thorough stirring before serving.

394

FLORIDA HEALTH NOTES

Food Poisoning

Of all places to contract food poisoning a wake would be the
most unlikely but State Board of Health's records show that this
happened in a North Florida city.

CASE HISTORY:

About 60 persons attending this wake ate the suspected foods
of cake, vegetable stew, macaroni and tuna, pork, green peas,
chicken and rice, and macaroni and cheese. Eleven persons became
ill within 30 minutes to four hours after eating; three of them
were seriously ill enough to be hospitalized. Nine persons had
handled the food and laboratory tests showed that the organism
staphylococcus was the cause. It was determined that someone
with a staph infection, other than the food handlers, was the source
of infection. The food had been prepared in private homes and
through the course of moving, the bacteria apparently had multi-
plied due to lack of refrigeration and protection.

CASE HISTORY:

Another type of food poisoning was discovered following an
investigation of a poorly operated kitchen of a Gulf coast hotel. Of
200 persons eating at the hotel at one time, 34 became ill. Sani-
tarians found that a meat slicer was cleaned with a rag from a
bucket of soapy water ; the same rag and water were used to clean
a table top and other equipment. Food carts were cleaned weekly
instead of daily and not steam-cleaned as required. The walk-in
refrigerator's drainage was incorrect. Meat was cooked and allowed
to cool by standing in pans on a table before being refrigerated; it
was then reheated and placed on food- warmers which were discon-
nected and open all the time the food was in them. The organism
found was Clostridium, a bacterium which has many species and is
found in battle wounds, the soil, sewage, meats, vegetables and
fruits not properly sanitized and appendices and intestines of men
and animals.

A sanitarian investigating this outbreak asked one kitchen em-
ployee for a specimen of his stool. The man delivered this and
when asked by the sanitarian if he had washed his hands after-
wards, replied, "No! They weren't dirty!" Examination revealed
both hands were contaminated.

FLORIDA HEALTH NOTES

395

Proving Food Poisoning

| HEN food poisoning is suspected, how does the laboratory
technician go about proving or disproving it? The process
is complicated and takes skilled hands and eyes and shrewd
analytical faculties.

Salmonella and Shigella organisms frequently enter the in-
testinal tract and may be recovered in the laboratory from stool
cultures. One of the problems is distinguishing other species of
bacteria which are present and which look like the offending
species.

Suspicious organisms are isolated in pure culture and then
subjected to special identification procedures:

• A heavy suspension of a stool specimen is smeared over the
surface of an agar which promotes growth. Several kinds of agar
are used because if only one is used, the results might fail.

• The plate is incubated for 18 to 24 hours and then inspected
for the presence of suspicious colonies. Any misleading organisms
must be screened out as early as possible so as not to confuse or
delay the prompt findings of any organisms being sought.

• Another screening procedure results in pure cultures of the
suspicious organisms for further study and indicates the techni-
cian's success in avoiding unsought colonies. At the same time
some hint may be given of the nature of the suspicious organisms.

• Selected isolated colonies are subcultured in test tubes and
inspected after incubation. The tubes are chemically treated but
even now Salmonella and Shigella may not be positively identified.

• Subinoculations of the growth from each selected tube are
made into other tubes. These may show results in two to four
hours but any negative tube is returned to the incubator for addi-
tional incubation. Delayed reaction may be of some assistance in
identification.

• The remaining cultures, whose reactions were consistent with
Salmonella or Shigella organisms and which were negative in the
tubes, are subjected to a series of biochemical and serological tests
for identification.

Few hospitals and private laboratories are equipped for com-
plete diagnostic services. It is more efficient for them to confine
themselves to providing prompt and accurate screening of suspici-

396 • FLORIDA HEALTH NOTES

NJ

A laboratory technician (above)
picks a colony of suspected bac-
teria from a petri dish; (right)
test tubes of Isolated colonies
are placed in an incubator where
the bacteria, if present, will mul-
tiply.

7

V^*

Proving Food Poisoning

I HEN food poisoning is suspected, how does the laboratory
technician go about proving- or disproving it? The process
is complicated and takes skilled hands and eyes and shrewd
analytical faculties.

Salmonella and Shigella organisms frequently enter the in-
testinal tract and may be recovered in the laboratory from stool
cultures. One of the problems is distinguishing other species of
bacteria which are present and which look like the offending
species.

Suspicious organisms are isolated in pure culture and then
subjected to special identification procedures :

• A heavy suspension of a stool specimen is smeared over the
surface of an agar which promotes growth. Several kinds of agar
are used because if only one is used, the results might fail.

• The plate is incubated for 18 to 24 hours and then inspected
for the presence of suspicious colonies. Any misleading organisms
must be screened out as early as possible so as not to confuse or
delay the prompt findings of any organisms being sought.

• Another screening procedure results in pure cultures of the
suspicious organisms for further study and indicates the techni-
cian's success in avoiding unsought colonies. At the same time
some hint may be given of the nature of the suspicious organisms.

• Selected isolated colonies are subcultured in test tubes and
inspected after incubation. The tubes are chemically treated but
even now Salmonella and Shigella may not be positively identified.

• Subinoculations of the growth from each selected tube are
made into other tul>es. These may show results in two to four
hours but any negative tube is returned to the incubator for addi-
tional Escubation, Delayed reaction may be of some assistance in
identification.

• The remaining cultures, whose reactions were consistent with
Salmonella or Shigella organisms and which were negative in the
tubes, are subjected to a series of biochemical and serological tests
for identification.

Few hospitals and private laboratories are equipped for com-
plete diagnostic services. It is more efficient for them to confine
themselves to providing prompt and accurate screening of suspici-

3% • FLORIDA HEALTH NOTES

t

A laboratory technician (above)
picks a colony of suspected bac-
teria from a petri dish; I right)
test tubes of isolated colonies
are placed in an incubator where
the bacteria, if present, will mul-
tiply.

ous organisms and rely upon the State Board of Health laboratories
for positive identification. This is particularly desirable since the
Board of Health has the legal responsibility in the matter of in-
fectious disease control.

Food Infections and Intoxications

| HERE are eight major categories of food-borne illnesses
and 40 specific diseases which may be transmitted if foods
are not prepared and handled according to the State Sani-
tary Code. If you become ill from any of these diseases, you will
experience one or more of these symptoms: diarrhea, fever, nausea,
abdominal pain, dizziness. Laboratory tests are the usual method of
diagnosing which type of pathogenic organism is causing the illness.
Some of the diseases, the foods involved and prevention are :

Illness

Foods Usually
Involved

Prevention

BACTERIAL FOOD INFECTIONS

Bacillary dysentery

Moist prepared
foods ; milk

Strict personal
cleanliness ; refrig-
erate moist foods

Undulant fever

Diphtheria

Streptococal food
infection

Typhoid fever

Raw contaminated
milk products

Milk contaminated
from human source

Food contaminated
by respiratory dis-
charge of carrier

Milk, shellfish,
other foods con-
taminated with
feces of human
cases or carriers

Pasteurization of
milk

Pasteurization of
milk

Cook food
thoroughly ; store
moist foods
under refrigeration

Pasteurize dairy
products; use cer-
tified shellfish,
chlorinate water;
eliminate flies

398

FLORIDA HEALTH NOTES

Illness

Foods Usually
Involved

Prevention

VIRAL FOOD INFECTIONS

Hepatitis

Acute viral
gastroenteritis

Botulism

Staphylococcal
food poisoning

Contaminated
shellfish or food
contaminated by a
person with the
hepatitis virus

Moist prepared
foods

Use shellfish from
approved sources;
cook foods
thoroughly; ex-
clude persons with
disease from
handling foods

Personal sanitation
and hygiene; serve
foods immediately
or hold hot

FOOD INTOXICATIONS

Home-processed
foods; contami-
nated canned foods

Cooked meats ;
cream -filled
pastries and other
dairy products;
bread puddings;
potato salad;
warmed-over foods

Cook foods
thoroughly; boil
15 minutes, stir
thoroughly

Exclude from food
handling persons
with nasal dis-
charge or skin
infection; keep hot
foods hot and cold
foods cold

PARASITIC INFECTIONS

Amoebic dysentery

Beef or pork
tapeworm

Water contami-
nated with sewage ;
moist food con-
taminated with
human feces

Insufficiently
cooked beef or
pork containing live
larvae

Personal sanita-
tion; protect water
supplies

Use approved meats
only

FLORIDA HEALTH NOTES

399

Illness

Arsenic lead
poisoning

Cyanide poisoning

Copper poisoning

Zinc poisoning

Foods Usually
Involved

CHEMICALS

Insecticide-con-
taminated foods

Food contaminated
with silver polish
containing cyanide

Any acid foods
which leaches
copper from
utensil surface

Food leaching from
galvanized ware

Prevention

Proper storage of
poisons

Do not use such
polish or thorough-
ly wash polish
from items

Prevent acid foods
from coming in
contact with
copper

Do not cook in
such ware

POISONOUS PLANTS AND ANIMALS

Barracuda Meat of the fish Do not eat

Shellfish poisoning Mussels

Florida's fresh-
water mussels are
all poisonous

Mushroom
poisoning

Rhubarb leaf
poisoning

Snakeroot
poisoning

Solanine poisoning

Poisonous mush-
rooms

Rhubarb leaves

Milk from cows
pastured on snake-
root

Green or sun-
burned potatoes;
wild celery

Use only
certified non-
poisonous varieties

Eat stalks only

Keep cows away
from plants

Do not use sprouts
or peelings from
such potatoes ; don't
eat the celery

m

400

FLORIDA HEALTH NOTES

PHYSICAL

Radiation poisoning Any food exposed Remove source;

to contamination constantly monitor

from radioactive suspected foods
materia]

You, Your Kitchen and the Law

ILORIDA'S subtropical climate creates a condition which
can contribute more readily to food poisoning than areas
in more temperate regions. Food which could be left unve-
frigerated in normally cool weather will spoil more quickly in
Florida's warm climate.

Community suppers can lead to trouble and often do. They are
frequently prepared in private kitchens where children and pets
have free range. With the exception of a dog guide, which may
accompany its master into a food service establishment, Florida
law prohibits live birds and animals from being in restaurants, in
vehicles used for transporting foods, or in facilities used to conduct
food service operations. These include any place where food or
drink is prepared and served for the public — whether a charge is
made or not. The regulations do not cover private homes but many
cases of food poisoning develop in private kitchens because of un-
sanitary conditions.

The Florida Sanitary Code requires cold foods served to the
public to be kept at 40 degrees Farenheit or below, and hot foods
be kept at 150 degrees or above — except during preparation and
service. This same rule should apply in the home.

Potentially hazardous foods, such as ham, chicken, egg, potato
and seafood salads "shall be prepared with a minimal manual con-
tact," according to the Florida Sanitary Code. In other words,
keep your hands out if at all possible; keep them thoroughly
washed; and NEVER use your hands for mixing salads if there
is a cut or rash on them.

Raw, unprocessed fruits and vegetables should be thoroughly
washed.

Frozen foods should be kept at degrees Farenheit and thawed

at 40 degrees or below under cold water, or quick-thawed as
of the cooking process.

part

FLORIDA HEALTH NOTES •

401

Illness

Arsenic lead
poisoning

Cyanide poisoning

Copper poisoning

Zinc poisoning

Foods Usually
Involved

CHEMICALS

Insecticide-con-
taminated foods

Food contaminated
with silver polish
containing cyanide

Any acid foods
which leaches
copper from
utensil surface

Food leaching from
galvanized ware

Prevention

Proper storage of
poisons

Do not use such
polish or thorough-
ly wash polish
from items

Prevent acid foods
from coming in
contact with
copper

Do not cook in
such ware

POISONOUS PLANTS AND ANIMALS

Barracuda Meat of the fish Do not eat

Shellfish poisoning Mussels

Florida's fresh-
water mussels are
all poisonous

Mushroom
poisoning

Rhubarb leaf
poisoning

Snakeroot
poisoning

Solanine poisoning

Poisonous mush-
rooms

Rhubarb leaves

Milk from cows
pastured on snake-
root

Green or sun-
burned potatoes;
wild celery

400

FLORIDA HEALTH NOTES

Use only
certified non-
poisonous varieties

Eat stalks only

Keep cows away
from plants

Do not use sprouts
or peelings from
such potatoes ; don't
eat the celery

PHYSICAL

Radiation poisoning

Any food exposed
to contamination
from radioactive

materia]

Remove source;
constantly monitor
suspected foods

You, Your Kitchen and the Law

|LORIDA'S subtropical climate creates a condition which
can contribute more readily to food poisoning than areas
in more temperate regions. Food which could be left unre-

frige rated in normally cool weather will spoil more quickly in

Florida's warm climate.

Community suppers can lead to trouble and often do. They are
frequently prepared in private kitchens where children and pets
have free range. With the exception of a dog guide, which may
accompany its master into a food service establishment, Florida
law prohibits live birds and animals from being in restaurants, in
vehicles used for transporting foods, or in facilities used to conduct
food service operations. These include any place where food or
drink is prepared and served for the public — whether a charge is
made or not. The regulations do not cover private homes but many
cases of food poisoning develop in private kitchens because of un-
sanitary conditions.

The Florida Sanitary Code requires cold foods served to the
public to be kept at 40 degrees Farenheit or below, and hot foods
be kept at 150 degrees or above — except during preparation and
service. This same rule should apply in the home.

Potentially hazardous foods, such as ham, chicken, egg, potato
and seafood salads "shall be prepared with a minimal manual con-
tact," according to the Florida Sanitary Code. In other words,
keep your hands out if at all possible; keep them thoroughly
washed; and NEVER use your hands for mixing salads if there
is a cut or rash on them.

Raw, unprocessed fruits and vegetables should be thoroughly
washed.

Frozen foods should be kept at degrees Farenheit and thawed
at 40 degrees or below under cold water, or quick-thawed as part
of the cooking process.

FLORIDA HEALTH NOTES

401

Pork products should be cooked to 150 degrees; stuffings,
stuffed meats, poultry should be cooked to at least 165 degrees
with no interruption of the cooking process. The stuffing of na-
tural crab shells is prohibited.

Employees of any food service establishment are prohibited
from using tobacco in any form while engaged in handling food or
equipment ; and he or she must thoroughly wash his or her hands
before resuming work after smoking.

This Information Can Help You

BTraaOU have read about the leading kind? of bacteria which
fnV&M can make you ill through food poisoning. We have told
By yj you what they look like; where they come from; how they
are carried from a source of infection or contamination to an in-
nocent person; and how they affect you.

We have said that there are some principles that can help
prevent such illness:

• strict personal hygiene, such as washing your hands after
using the toilet and before handling foods;

• cooking foods thoroughly; and

• storing foods at proper temperature. A good rule of thumb
is to keep foods either cold or hot.

The State Board of Health laboratories are open 365 days a
year, keeping watch on foods you may eat and trying to discover
what may have made you ill. We have told you how technicians go
about their exacting work.

Let us hope you never have food poisoning. But suppose you
do. If it's minor, you'll probably pay little attention to it. But
if you're really sick, you should see your family physician. If you
were at a picnic yesterday, or a group supper last evening, tell him
what foods you ate and who else was at the gathering. They also
may become ill and this will help trace the cause. If you have not
eaten out, the food in your own kitchen may have been contami-
nated. This is no time to be ashamed. It is important to you and
your physician that you get well as quickly as possible. Only by
helping him discover the cause can this happen.

Remember, failure to detect and report food poisoning could
cost you your life.

402 • FLORIDA HEALTH NOTES

IDA STATE UBRABY.

P"i'k products should l>e cooked lo ISO degrees; stuffings,
stuffed meats, poultry should tie cooked '" at leasl Hi"> degrees

wiih no Interruption t»f the < king process. The stuffing of na-

tuml crab shells is prohibited.

Employees of any food service establishment are prohibited
from using tobacco in tiny form while engaged in handling food en
equipment . ami !■<• in she must thoroughly wash his or her hands
liefi ming work after smoking.

This Informal ion Can Help You

jvpjgamr have read ubottl the leading kinds of bacteria which
NAjfcH can make you ill through food poistining. Wc have told
u3> Ea you what the> took like: where they come from; how they
are carried from n kouii a of iufection or contamination to an In-
nocent person: und how they affed you.

We have sail I thai there are some principles that can help
prevent such illm

• strict personal ne, s ich as washing your hands after
using the toilet and before handling food

• conking foods thoroughly; and

• storing food's ai proper temperature. A good rule of thuml>
is to keep foods either cold or hot.

The Stale Board uf Health laboratories are open 865 days a
ng watch t>n foods ynu may eat and trying to discover
what may have made yon ill. We have told you how technicians go
aUntt I heir exacting work.

Lei us hope you never have food poisoning. I'm -appose you
tlo. If it's minor, you'll proliably pay little attention to it. But
if you're u-alh sick, ynu should see your family physician. If you
were ai a picnic yesterday, w n group supper Inst evenin.tr. tell him
what foods you ate and who else was ai the gathering. They also
may liecome ill and this will help trace the cause. If you have not
eaten out. I il in com own kitchen may have lieen contami-

nated. This i< no tini. ashamed. It is important to you and

ytuir physician thai you pet well as quickly as possible. Only by
helping him dLscovei the < nuse can this happen.

Remember, failure t« detect and repot t food poisoning could
you your life.

402

FLORIDA HEALTH NOTES

FLORIDA

HEALTH
NOTES

KC 1BER

— NO. 12

1967

in PUBLIC HEALTH

£

LOFW ■» STATE LIBRARY.

in PUBLIC HEALTH

When a man finds himself without food or shelter, he takes
things into his own hands and does something about it. But if
disease strikes, he must turn elsewhere for help. In the past he
has turned to the supernatural, to the priest, or to the medicine
man. Today, man turns to the physician and the trained people who
assist him.

By tradition and because of lengthy and comprehensive scien-
tific training and medical orientation, the physician is the key
person on this health team. But he has many partners and his ef-
fectiveness depends on other members of the team. Public health,
which deals with the health of the community as contrasted to
individual health, also requires the services of dentists, health edu-
cators, laboratory workers, nurses, office workers, sanitarians,
sanitary engineers, secretaries and x-ray technicians — just to
name a few. These people are helping their fellowman to better
health — which is physical good health, freedom of disease and
a "sense of well-being."

Choosing any career as your lifetime vocation is an important
decision. Selecting a public health career is a rewarding decision
because working for health is more than just a job. It is a point
of view and a way of looking at life — including your own life and
the lives of other people you meet, serve and work with every day.

Public health needs all kinds of people with all kinds of skills.
The public health team has a place

FLORIDA HEALTH NOTES

407

(Cover p h o t o ' Microscope,
stethoscope, blood pressure
cuff, tooth model, test tubes,
movie film, computer tope, low
and vital statistics books are
just a few of the tools thot
represent the wide range of
careers in public health.

The clinical specialist's is one
of the many fields in public
health for medical practition-
ers. Other areas of work in-
clude administration, research,
epidemiology and planning.

in PUBLIC HEALTH

When a man finds himself without food or shelter, he takes
things into his own hands and does something about it. But if
disease strikes, he must turn elsewhere for help. In the past he
has turned to the supernatural, to the priest, or to the medicine
man. Today, man turns to the physician and the trained people who
assist him.

By tradition and because of lengthy and comprehensive scien-
tific training and medical orientation, the physician is the key
person on this health team. But he has many partners and his ef-
fectiveness depends on other members of the team. Public health,
which deals with the health of the community as contrasted to
individual health, also requires the services of dentists, health edu-
cators, laboratory workers, nurses, office workers, sanitarians,
sanitary engineers, secretaries and x-ray technicians — just to
name a few. These people are helping their fellowman to better
health — which is physical good health, freedom of disease and
a "sense of well-being."

Choosing any career as your lifetime vocation is an important
decision. Selecting a public health career is a rewarding decision
because working for health is more than just a job. It is a point
of view and a way of looking at life — including your own life and
the lives of other people you meet, serve and work with every day.

Public health needs all kinds of people with all kinds of skills.
The public health team has a place

FLORIDA HEALTH NOTES • 407

for those who enjoy working with people and have a special
gift of sympathy and understanding;

for those who like to work alone in research and laboratories;

for those who are efficient managers and administrators;

for those who are good at typing and clerical skills;

for those who like to work with their hands, run machines and
operate equipment;

for those who have an aptitude for mathematics and science;
for those who like to teach, write, take pictures and do art work ;

for those who are interested in food and housekeeping; and
especially

for those who have a desire to help other people.

If you like to do any of these things, public health in Florida
has a place for you. There is always a need for well-qualified pro-
fessional people to fill positions in various fields in public health.
There is also a need for skilled nonprofessional people, such as
clerks, home health aides, laboratory technicians, secretaries, clerk-
typists and laborers.

This issue of Florida Health Notes has a two-fold purpose. It
will

*tell you who are looking for a purpose in life about the re-
wards of a health career and what are the qualifications for the
various disciplines; and

*tell you who have found your position or have already estab-
lished a career about the variety of workers found in the public
health field in Florida.

FLORIDA HEALTH NOTES

Published monthly by the Florida Stole Boord of Health, WilKm T. Sowder, M.D., M.P.H .,
State Health Officer. Publication office. Box 210, Jacksonville, Florida 32201. Second class
postage paid at Jacksonville; Florida. This publication is for individuals and institutions with
on interest in the state's health programs. Permission is given to quote any story providing
credit it o'ven to the Florida State Board of Health. Editor; Robert A, Schoonover, M.A.,
Division of Health Educotian.

VOLUME S9— HO. 12 DECEMBER 19C7

408 • FLORIDA HEALTH NOTES

MtM turn fkd?

People in the health field often think of themselves as having
a career rather than a job, and any student who is considering
what to do with his life will find that from the moment he makes
a decision to enter the health field he will have a feeling of pride
in his choice. Although no two health careers are alike, they have
much in common, purpose and outlook for the future. But still the
health field is so diversified that educational requirements vary in
the different disciplines.

There are three main steps in planning a career:

Information — Seek published information from professional
organizations, colleges, universities, schools and voluntary and
governmental health agencies. Find out the possibilities of getting
a scholarship or some other form of student assistance if you
need it. Take the opportunity to talk to people in the field in which
you are interested.

Counseling — Talk to an experienced advisor, either at school or
the state employment service. Personnel in the State Board of
Health and County Health Departments will be happy to counsel
with you about careers in public health. If possible take aptitude
tests which will show what work you are best suited for. Seek
advice of people who are interested in the health field and par-

A physician and public
health nurse examine an
infant at a well-baby
clinic. Pediatrics is one
important area of public
health work for physi-
cians.

^

I

■■

ticularly of people who are leaders in the profession in which you
are interested. Take into consideration the cost of the necessary
education and possibilities of graduate training, and plan accord-
ingly.

Initiative — Don't rush into an all-or-nothing career or one that
is less adaptable to different situations. Most of the basic skills
needed in the health field can be applied to many occupations. The
student may have to take into account changing circumstances,
such as finances, scholastic standings and personal or family mat-
ters. An adaptable occupation has real advantages. Young men who
need to consider military obligations should plan to use, through
the various Armed Forces' programs, this time for furthering
their education and training rather than considering the period as
an interruption of their career. The Armed Forces need and do de-
velop and utilize nearly every kind of health skill.

CAREERS REQUIRING HIGHER EDUCATION

There are a number of public health careers which require a
baccalaureate degree or higher. Some professions, such as dentists,
engineers, physicians and social scientists, demand many years of
additional schooling and training beyond the usual four years. In
some disciplines a master's degree in public health, sanitary en-
gineering, biological or physical sciences is becoming more and
more a prerequisite for employment or advancement. Following
are qualifications and duties for 37 classifications in the public
health field which require additional education beyond high school.

THE PHYSICIAN

Education for a physician demands four years of premedical
school with an emphasis on the sciences, four or more years of
education and graduation from an accredited medical school, in-
ternship, and sometimes a period as a resident physician in a hos-
pital. For the public health field in Florida, the physician may
also be certified by the American Board of Preventive Medicine and
he must be eligible to be licensed as a physician by the Florida
State Board of Medical Examiners.

410 • FLORIDA HEALTH NOTES

*The Administrator (including the director of a County Health
Department) is a physician who is a recognized and experienced
specialist in public health. The director looks to his professional
staff to take responsibilities for the public health services, but he
is the one who directs the various programs, makes policy decisions
and is answerable to the governmental unit under which the agency
operates.

•The Specialist in public health administration heads special
disease control programs and may direct one of the services ren-
dered by the modern health department

•The Researcher is a physician who teams up with the social
scientist, the physiologist, the psychologist, the biologist, the
chemist and many others to carry on research. In Florida, research
is being carried on in such fields as arthropod-borne diseases, pesti-
cides, infant and maternal care and retardation.

•The Clinical Specialist can go into some 20 fields, including ob-
stetrics and gynecology (management of childbirth and women's
diseases), pediatrics (medical care of children) and ophthalmology
(treatment of the eye and its diseases).

•The Epidemologist is a physician who works in the field of
disease detection and prevention. He combines scientific facts with
everyday situations to seek out the causes of communicable disease
epidemics and promotes preventive measures.

•The Program Planner is a physician who is concerned with the
planning of health programs and who evaluates the results as a
basis for improving the services of the health department. His goal
is to bring about more effective public health programs and pro-
ductive use of time, space, personnel and equipment.

NURSING AND PARAMEDICAL

There are few areas of endeavor that offer more satisfaction
than public health nursing, physical therapy or health field work.
These disciplines are ones which work closely with the people of
Florida. Because of the shortage of professional nurses, the State
Board of Health and County Health Departments maintain a con-
stant program of recruitment.

FLORIDA HEALTH NOTES • 411

inanities and biological and physical sciences. Duties: works with
physician and nurse, members of the health team, to help patients
overcome their disabilities through treatment by physical and
medical means (massage, exercise, water, light, heat and elec-
tricity).

* Health Field Worker — requires a four-year college degree.
Duties: carries out field investigations and educational work in the
control and prevention of communicable diseases by interviewing
infected persons, tracing source of infections and informing in-
fected persons of the requirements of disease control programs
and the facilities for treatment.

ENVIRONMENTAL HEALTH

At one time, back in the early days, there was little to pollute
either the water or air, and certainly, in those days, no one antici-
pated a time when the disposing of radioactive wastes would chal-
lenge the best minds of the public health field. Today the growth
of population, the many kinds of waste which are the by-products
of our homes, businesses, farms and industries threaten to over-
whelm us. This work calls for sanitary engineers, sanitarians, en-
tomologists, industrial hygienists and air pollution specialists.

*Sanitary Engineer — requires a college degree in engineering;
civil, chemical and sanitary are the most common degrees; a mas-
ter's degree in sanitary engineering or public health is helpful for
advancement. Duties: include responsibilities for programs which
ensure the provision of safe drinking water sources, the satisfac-
tory operation of water supply systems and water purification
processes, the control of recreational and shellfish waters, the de-
sign and operation of sewage collection and treatment facilities,
the control of air pollution and many important activities.

* Sanitarian — since 1960 has required a degree from a four-
year college with emphasis on biological, chemical, physical and
health sciences. Duties: Primary goal is to find and remove health
hazards in order to make the physical environment safe for every-
one ; undertakes various types of field work, including inspection of
food service and processing establishments, schools, dairies, trailer
parks; investigates public health nuisance complaints; and does
rabies control work. Specialization may be undertaken in many

FLORIDA HEALTH NOTES

413

A public health nurse, as-
sisted by o gray lady volun-
teer, takes the blood
pressure of a patient in a
County Health Department
clinic. The clinic is just one
activity of the public health
nurse.

♦Public Health Nurse — There are two categories in nursing
education: the hospital or independent school which offers a di-
ploma program and the college or university which gives a bacca-
laureate degree in four veins. Duties: As part of the public health
team, the nurse is concerned not only with the sick but also with
the prevention of illness. She gives nursing service in the home,
school, office and industry. In the County Health Department
clinics, she gives immunizations, assists the physician with exam-
inations, does blood tests, hearing and vision tests, and gives in-
jections as ordered by the physician. A large and very important
portion of the nurse's time is given in educating her patients in
the ways of better health.

•Physical Therapist — Some colleges give a four-year course
leading to a bachelor of science degree ; other schools have a "cer-
tificate program" for those who have completed all or most of their
undergraduate work, provided it has included subjects in the hu-

412 • FLORIDA HEALTH NOTES

manities and biological and physical sciences. Duties: works with
physician and nurse, members of the health team, to help patients
overcome their disabilities through treatment by physical and
medical means (massage, exercise, water, light, heat and elec-
tricity).

•Health Field Worker — requires a four-year college degree.
Duties: carries out field investigations and educational work in the
control and prevention of communicable diseases by interviewing
infected persons, tracing source of infections and informing in-
fected persons of the requirements of disease control programs
and the facilities for treatment.

ENVIRONMENTAL HEALTH

At one time, back in the early days, there was little to pollute
either the water or air, and certainly, in those days, no one antici-
pated a time when the disposing of radioactive wastes would chal-
lenge the best minds of the public health field. Today the growth
of population, the many kinds of waste which are the by-products
of our homes, businesses, farms and industries threaten to over-
whelm us. This work calls for sanitary engineers, sanitarians, en-
tomologists, industrial hygienists and air pollution specialists.

'Sanitary Engineer — requires a college degree in engineering;
mil. chemical and sanitary are the most common degrees; a mas-
ter's degree in sanitary engineering or public health is helpful for
advancement. Duties: include responsibilities for programs which
ensure the provision of safe drinking water sources, the satisfac-
tory operation of water supply systems and water purification
processes, the control of recreational and shellfish waters, the de-
sign and operation of sewage collection and treatment facilities,
the control of air pollution and many important activities.

* Sanitarian — since 1960 has required a degree from a four-
year college with emphasis on biological, chemical, physical and
health sciences. Duties: Primary goal is to find and remove health
hazards in order to make the physical environment safe for every-
one; undertakes various types of field work, including inspection of
food service and processing establishments, schools, dairies, trailer
parks; investigates public health nuisance complaints; and does
rabies control work. Specialization may be undertaken in many

FLORIDA HEALTH NOTES • 413

•Draftsman — A college degree is not a prerequisite for this
position but college education in the field of pre-engineering train-
ing, in mechanical drawing, plus experience will aid greatly toward
advancement. Duties: works with sanitary engineers on plans for
sewage treatment and water supply facilities; does illustrations
for publications, posters, etc.

LABORATORIES

Public health has need of more and more scientists who work
closely with all disciplines to prevent and control disease. The focal
points for work In the health sciences are the regional laboratories
in Miami, Orlando, Tampa, Pensacola, Tallahassee and West Palm
Beach ; the central laboratory in Jacksonville ; and the two labora-
tories in Brevard and Pinellas County Health Departments. Studies
which help with the diagnosis and treatment of disease are carried
on in these laboratories. Tests are also made of food, water, sew-
age and industrial waste, milk and dairy products, and radiological
specimens. Field trips are made for investigations and inspections.

Employment is exceptionally good for well-qualified young
people. The outstanding college graduate who has a bachelor's de-
gree with a major in chemistry, biology, bacteriology, physiology
or physics will find the work he wants in the public health labora-
tory.

•Biologist — requires a college degree in biology or zoology;
graduate study and laboratory experience will help toward advance-

Sanitarians check the
chlorine content of a motel
swimming pool. This is just
one of the many activities
they carry on to find and
remove environmental
health hazards.

Qsfti

Environmental health is partly the responsibility of the sanitary engineer.
This includes the design and operation of sewage collection and treatment
facilities.

specific areas, such as food sanitation, pollution control or swim-
ming pools.

*Entomologist — requires a college degree in one of the biologi-
cal sciences; a master's degree or doctor of philosophy with major
courses in entomology may lead to advancement. Duties: under-
takes field and laboratory work in the control of insects and or
rodents that transmit disease to man or prey on crops. He must
keep himself informed on all techniques and methods available as
precautions in the use of insecticides and pesticides.

•Physicist — requires a college degree in one of the physical
or biological sciences. Duties: carries on field and laboratory work
in the investigation and control of ionizing radiation and other
physical phenomena potentially hazardous to man.

•Industrial Hygienist — requires a college degree with a major
in chemical engineering or one of the physical sciences. Duties: to
recognize industrial hazards, such as toxic gases, dust, vapors and
fumes, noise or lighting conditions; to evaluate the magnitude of
the hazards and to prescribe ways of eliminating or controlling
them.

414

FLORIDA HEALTH NOTES

I-.1

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*

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^

The laboratory has many types of specializations for the college-trained
person. There are also many positions available for laboratory technicians
who do not have this type of education.

ment. Duties: scientific and field work in stream biology and the
study of plants and animals and the diseases these forms of life
can transmit to humans.

•Chemist — a college degree in chemistry or a baccalaureate
degree with at least 20 semester hours of chemistry; a master's
degree in chemistry or chemical engineering is helpful for advance-
ment. Duties: exacting laboratory work in chemical testing and
analyses in such fields as toxicology, pesticides, industrial hygiene,
air pollution control, industrial wastes and sewage treatment and
public water supply.

•Microbiologist — a college degree with a major in one of the
biological sciences; advanced studies in microbiology or public
health will help toward advancement. Duties: perform exacting
and skilled laboratory work in the carrying out of a wide variety
of examinations and tests which are an integral and essential part
of the community health protection services administered by the
State Board of Health and County Health Departments.

•Other specialties in the public health laboratory which are re-
lated to the main classifications are:

bacteriology — the study of the growth and spread of bacteria ;

parasitology — the study of parasites;

virology — the study of viruses and viral diseases ;

416

FLORIDA HEALTH NOTES

in

The laboratory has many types of specializations for the college-trained
person. There ore also many positions available for laboratory technicians
who do not have this type of education.

ment. Duties: scientific and field work in stream biology and the

study of plants and animals and the diseases these forms of life
can transmit to humans.

*Chemist - — a college degree in chemistry or a baccalaureate
degree with at least 20 semester hours of chemistry; a master's
degree in chemistry or chemical engineering is helpful for advance-
ment. Duties: exacting laboratory work in chemical testing and
analyses in such fields as toxicology, pesticides, industrial hygiene,
air pollution control, industrial wastes and sewage treatment and
public water supply.

* Microbiologist — a college degree with a major in one of the
biological sciences; advanced studies in microbiology or public
health will help toward advancement. Duties: perform exacting
and skilled laboratory work in the carrying out of a wide variety
of examinations and tests which are an integral and essentia! part
of the community health protection services administered by the
State Board of Health and County Health Departments.

*Other specialties in the public health laboratory which are re-
lated to the main classifications are:

bacteriology — the study of the growth and spread of bacteria;

parasitology — the study of parasites;

virology — the study of viruses and viral diseases ;

416

FLORIDA HEALTH NOTES

serology — the study of serums and their actions;

hematology — the exa mi nation and testing of blood specimens
and interpretation of the results to aid in diag-
nosis and treatment of certain diseases;

mycology — a specialization in fungi ; and

toxicology — the study of poisons

DENTAL HEALTH

Dental health is a field of life-time opportunity for the quali-
fied professional person. The demands for dentists far exceed the
supply of capable trained personnel. Whereas the dentist in private
practice works with the individual, the public health dentist's in-
terest extends beyond the individual to include the total denlnl
health of the community. He stresses the importance of preventive
dental health and all services which maintain it.

♦Dentist — a college degree with emphasis on the sciences; a
doctorate of dental surgery m dental medicine; and licensed to
practice in Florida. Duties: perform professional work in dental
and oral surgical services and the full range of dental duties in ex-
amination, treatment and complete dental care of schoolchildren
and certified indigent children and adults.

* Dental Hygienist — graduation from an approved school of
dental hygiene and certified by the Florida Board of Dental Exam-
iners. Duties: technical dental hygienic work not requiring the
services of a professional dentist, involving examination ami oral
prophylaxis and including promotion of dental health education in
schools.

The public health dentist
and dental hygienist
chek the teeth of
sch ichildrcn and give
der al care to indigent
cas ;. They also promote
der al education for the
ent e community.

HEALTH EDUCATION

Sometimes people suffer from illnesses that could be prevented
or fail to behave in a way to promote good health because they
don't know or understand the facts. They frequently fail to make
the most of health progress because they have not been able to keep
up with the bewildering pace of scientific change. It is the job of
the health educator, along with other health workers, to translate
these scientific advances into everyday, usable form and to help
people help themselves — individually or in groups.

* Health Educator — college degree in education with specializa-
tion in health, science or sanitary science. Duties: information and
liaison work with community groups, stimulating people in the com-
munity to recognize health problems of which they may not be
aware and to work for their solution. Assists other public health
workers in planning educational programs for the State Board of
Health and County Health Departments. Works with civic groups,
voluntary health agencies, schools, etc.

•School Health Coordinator — a college degree and experience
as a classroom teacher and/or school administrator; a master's
degree or doctorate in education may be helpful for promotions.

The health educator tries to stimulate people in the community to re-
cognize health problems and to work for their solution.

£L

Duties: consults with governmental, educational and community
groups in planning health programs for schools and introducing
these programs into the state's school system.

"Information Specialist — a college degree in journalism and ex-
perience in newspaper writing, publicity or editing; a master's
degree in journalism, English, public relations or speech may be
helpful for advancement. Duties: specialization in writing, editing
and publishing information about health and carrying on a public
information program in behalf of the State Board of Health and
County Health Departments.

'Medical Librarian — a college degree in library science. Duties:
responsible for the planning and managing of a library involving
the selecting, classifying, cataloging, shelving and circulating of
library books and materials maintained for research and public
information.

VITAL STATISTICS, NONMEDICAL AND ADMINISTRATIVE

There are a number of people involved in public health who are
not scientists, physicians, educators or dentists but who are impor-
tant because they keep records, handle finances, audit books, an-
alyze programs and assist the State Health Officer and directors
of the County Health Departments with the administration of
health services.

"Statistician — a degree from a four-year college with major
emphasis on statistics, mathematics or either biological or physical
science, providing there are three or more semester hours of
statistics ; a master's degree in statistics or mathematics is helpful
for advancement. Duties: technical research and statistical work
in the compilation, analyzing and interpreting of public health data
in relation to health and disease.

"Accountant — a college degree with at least 12 semester hours
in accounting; a master's degree or the possession of a Certified
Public Accountant's license is helpful for advancement. Duties:
carry on the cost accounting system of the State Board of Health

FLORIDA HEALTH NOTES

419

OTHER SPECIALISTS IN PUBLIC HEALTH

The public health field needs the services of a wide range of pro-
fessional people who are also found in other areas of activity or
private practice. Some of these specialists, such as veterinarians
and nutritionists, have been in the public health field for many
years; the attorney and social scientists are virtually newcomers
and many people do not think of them as public health workers.

•Veterinarian — graduation from a school of veterinary med-
icine; licensed or eligible for licensing by the Florida State Board of
Veterinary Examiners. Duties: responsible for control work in dis-
eases transmissible from animals to man; serve as technical con-
sultant to local health officers on veterinary problems relating to
public health or as animal pathologist in the laboratory diagnosis of
biological specimens.

•Nutritionist — a college degree in home economics and a
dietetic internship; a master's degree in nutrition or public health
is helpful for advancement. Duties: responsible for promoting edu-
cational programs in nutrition, helping County Health Departments
to develop nutrition programs, assisting in staff training, planning
publicity and organizing and developing community nutrition pro-
grams. They also provide nutrition instructions to individuals on
special diets and persons with nutrition problems.

The public health veterinarian
is responsible for control work
in diseases which are transmis-
sible from animals to man.

The statistician compiles,
analyzes, interprets and trans-
lates data into meaningful in-
formation which will help fight
disease.

and County Health Departments which shows the exact cost of
programs and the preparation of the projected budget by which all
future expenditures are controlled.

* Auditor — a college degree in accounting and certification by
the Florida State Board of Accountancy. Duties: responsible for the
examining of accounting records and financial statements of the
State Board of Health and County Health Departments.

♦Health Program Specialist — a master's degree in public health
or hospital administration and four to six years experience with
increasing responsibilities in public health programs, including two
to three years in an administrative capacity. Duties: responsible
for planning, developing and evaluating health programs for a
County Health Department or the State Board of Health.

•Personnel Manager, Technician or Officer — a college degree
with major work in the field of social sciences or public or business
administration. Duties: handles all phases of the personnel work in
the State Board of Health and County Health Departments.

•Administrative Assistant — a college degree in public or busi-
ness administration. Duties: assists in the administering of a large
County Health Department or one of the bureaus, divisions or pro-
grams of the State Board of Health.

420

FLORIDA HEALTH NOTES

* Attorney — a law degree and admission to the Florida Bar
Association. Duties: responsible for advising the State Health Of-
ficer and the staff of the State Board of Health on legal matters,
providing the Board with legal services, and representing the
agency in court trials.

♦Social Scientist — a doctorate or a master's degree in one
combination of the social sciences and two to four years experience
in public health, vocational rehabilitation counseling, clinical social
work or other closely related fields. A master's degree in public
health may be in lieu of experience. Duties: concerned with the
origin and role of social groups and behavior. Responsible for
correlating social action principles and practices into a specific
public health program and the planning, developing, installing and
directing of a social science program in a County Health Depart-
ment.

'Medical Social Worker — a master's degree from a school of
social work based upon completion of two years of graduate study,
including courses in casework, psychiatric and medical informa-
tion and supervised field work: and one year of experience in a
clinical setting with specialization in social casework. Duties:
applying clinical social work in a public health clinic.

"Pharmacist — graduation from a school of pharmacy and regis-
tration by the Florida Board of Pharmacy. Duties: purchase and
distribute drugs for the State Board of Health and County Health
Departments: fill prescriptions for indigent patients, as indicated
by county health officers and private physicians: give consultative
services to County Health Departments.

"Health Mobilization Coordinator — a college degree and one
or more year's experience in public health. Duties: responsible for
the coardination of health services which are concerned with the
training and survival of Florida citizens in times of natural or man-
made disasters.

POSITIONS NOT REQUIRING A COLLEGE EDUCATION

There are many positions in the public health field which do not
require a college degree but which are staffed by people necessary
for the smooth operation of the State Board of Health and County
Health Departments. Some of the 14 following classifications re-
quire only a high school diploma while others, such as a position
for x-ray technician, have a prerequisite of technical training.

422 • FLORIDA HEALTH NOTES

The nutritionist promotes
better health through
proper diet and wise
choice of foods.

CLERICAL

Important in every County Health Department and office of
the State Board of Health are the clerical personnel who type let-
ters, file records and correspondence, and do the many jobs which
make an office function smoothly. They are also valuable for their
public relations responsibilities — meeting, greeting and directing
the public to the right individuals. A high school education is nec-
essary ; further education in commercial or secretarial science may
be helpful for advancement.

♦Secretary — responsible for secretarial work and taking and
transcribing oral dictation ; must be able to take 80 words a minute
in dictation and type 35 words a minute.

*Clerk -Typist — must be able to do fairly complex clerical work
and must be able to type 35 words a minute.

*Clerk — must be able to do general clerical work, such as fil-
ing, etc.; advanced positions do more supervisory and technically
varied work.

DATA PROCESSING

A position in this field requires at least a high school education;
additional education and/or experience may help for promotion or
advanced classification.

•Key Punch Operator ■ — performs rapid and accurate work in
punching coded or uncoded data into electronic data processing
machinery cards.

FLORIDA HEALTH NOTES

423

■■■■i

♦Attorney — a law degree and admission to the Florida Bar
Association. Duties: responsible for advising the State Health Of-
ficer and the staff of the State Board of Health on legal matters,
providing- the Board with legal services, and representing the
agency in court trials.

^Social Scientist — a doctorate or a master's degree in one
combination of the social sciences and two to four years experience
in public health, vocational rehabilitation counseling, clinical social
work or other closely related fields. A master's degree in public
health may be in lieu of experience. Duties: concerned with the
origin and role of social groups and behavior. Responsible for
correlating social action principles and practices into a specific
public health program and the planning, developing, installing and
directing of a social science program in a County Health Depart-
ment.

•Medical Social Worker — a master's degree from a school of
social work based upon completion of two years of graduate study,
including courses in casework, psychiatric and medical informa-
tion and supervised field work; and one year of experience in a
clinical setting with specialization in social casework. Duties;
applying clinical social work in a public health clinic.

•Pharmacist — graduation from a school of pharmacy and regis-
tration by the Florida Board of Pharmacy. Duties: purchase and
distribute drugs for the State Board of Health and County Health
Departments; fill prescriptions for indigent patients, as indicated
by county health officers and private physicians ; give consultative
services to County Health Departments.

•Health Mobilization Coordinator — a college degree and one
or more year's experience in public health. Duties: responsible for
the coordination of health services which are concerned with the
training and survival of Florida citizens in times of natural or man-
made disasters.

POSITIONS NOT REQUIRING A COLLEGE EDUCATION

There are many positions in the public health field which do not
require a college degree but which are staffed by people necessary
for the smooth operation of the State Board of Health and County
Health Departments. Some of the 14 following classifications re-
quire only a high school diploma while others, such as a position
for x-ray technician, have a prerequisite of technical training.

422 • FLORIDA HEALTH NOTES

The nutritionist promotes
better health through
proper diet and wise
choice of foods.

CLERICAL

Important in every County Health Department and office of
the State Board of Health are the clerical personnel who type let-
ters, file records and correspondence, and do the many jobs which
make an office function smoothly. They are also valuable for their
public relations responsibilities — meeting, greeting and directing
the public to the right individuals. A high school education is nec-
essary ; further education in commercial or secretarial science may
be helpful for advancement.

♦Secretary — responsible for secretarial work and taking and
transcribing oral dictation ; must be able to take 80 words a minute
in dictation and type 35 words a minute.

♦Clerk-Typist — must be able to do fairly complex clerical work
and must be able to type 35 words a minute.

♦Clerk — must be able to do general clerical work, such as fil-
ing, etc.; advanced positions do more supervisory and technically
varied work.

DATA PROCESSING

A position in this field requires at least a high school education ;
additional education and or experience may help for promotion or
advanced classification.

*Key Punch Operator — performs rapid and accurate work in
punching coded or uncoded data into electronic data processing
machinery cards.

FLORIDA HEALTH NOTES

423

I

m

"Data Processor — carries on the rapid and accurate operation
of a variety of punch card tabulating machines, or the clerical ac-
counting and statistical work in a data processing machine instal-
lation.

OTHER PERSONNEL

•X-ray Technician — requires a high school education plus a
course in x-ray training; operates and maintains x-ray equipment,
plus the operation of mobile or portable x-ray unit.

•Laboratory Technician — Although a high school or vocational
school education is necessary, college work in zoology, chemistry,
bacteriology or related fields may be helpful for advancement;
performs a wide variety of laboratory examinations and tests.

•Rabies Control Worker — investigates and picks up unlicensed
and diseased animals, especially those suffering from rabies.

•Sprayman — works with mosquito control and eradication pro-
gram in the control of insects; inspects vacant lots and premises
for mosquito breeding and sprays water-holding containers and
shrubs to kill insects.

•Sanitary Aide — picks up water samples, checks garbage
dumps and carries out environmental health work which is not of
a professional nature.

•Home Health Aide — receives two weeks training prior to
being assigned to a case ; renders personal care to the sick person
in the home on the orders of a physician and under the supervision
of a registered nurse.

•Clinic Aide — carries on clerical and housekeeping duties in
the County Health Department clinics ; is involved in the prepara-
tion of treatment rooms for use by patients; cleans rooms and
equipment after clinics; and performs routine filing.

•Foreman and Maintenance Man — responsible for the super-
vision and semi-skilled and skilled work in several trades which
are necessary for the maintenance and repair of buildings and
equipment.

•Laborer - — a minimum education of six grades is required
and employees must be able to read and write; includes such
workers as domestics and janitorial workers, custodial and security
guards.

424 • FLORIDA HEALTH NOTES

Sdolmhipi . . .

The high school student who is interested in a health career
may find various kinds of scholarships available through the State
Department of Education or through the student financial aid
office of the university or college of his choice. These scholarships
are available in limited numbers and are usually awarded on the
basis of academic excellence, good character, leadership and finan-
cial need. There are also loans or scholarships available through
various federal and state programs and from professional organiza-
tions, such as medical, nursing and engineering societies, and fra-
ternal and civic groups.

Many civic and professional organizations both on a state and
national level, award scholarships for undergraduate and graduate
work in nursing education. The Florida Nursing Association spon-
sors a scholarship program — with money appropriated by each
session of the Florida Legislature — which helps both licensed prac-
tical nurses and two, three and four year nursing students.

High school seniors take competitive examinations each October
for these scholarships which are awarded the following year. A
Nurses Training Act, sponsored by the Federal Government, also
provides scholarships for senior undergraduate and graduate nurs-
ing students who show outstanding leadership ability.

The State Board of Health offers graduate scholarships for
outstanding staff members which may lead to a master's degree in
public health, sanitary engineering, bacteriology or other special
areas. These are mostly for one year, but occasionally a scholarship
may be for a two or three year period. Exceptions have been made
in the past for scholarships to certain long-time employees which
have permitted them to complete undergraduate degrees.

The State Board of Health also administers one osteopathic and
five dental scholarships each year. For each $2000 dental students
receive, they must work one year in an area of need designated by
the State Board of Health or in a public health clinic. At the present
time, 21 dentists have completed their obligated service by serving
the people in rural areas of Florida. The osteopathic scholarship is

FLORIDA HEALTH NOTES

425

■

•Data Processor — carries on the rapid and accurate operation
of a variety of punch card tabulating machines, or the clerical ac-
counting and statistical work in a data processing machine instal-
lation.

OTHER PERSONNEL

* X-ray Technician — requires a high school education plus a
course in x-ray training; operates and maintains x-ray equipment,
plus the operation of mobile or portable x-ray unit.

•Laboratory Technician — Although a high school or vocational
school education is necessary, college work in zoology, chemistry,
bacteriology or related fields may be helpful for advancement;
performs a wide variety of laboratory examinations and tests.

'Rabies Control Worker — investigates and picks up unlicensed
and diseased animals, especially those suffering from rabies.

•Sprayman — works with mosquito control and eradication pro-
gram in the control of insects; inspects vacant lots and premises
for mosquito breeding and sprays water-holding containers and
shrubs to kill insects.

•Sanitary Aide — picks up water samples, checks garbage
dumps and carries out environmental health work which is not of
a professional nature.

•Home Health Aide — receives two weeks training prior to
being assigned to a case; renders personal care to the sick person
in the home on the orders of a physician and under the supervision
of a registered nurse.

♦Clinic Aide — carries on clerical and housekeeping duties in
the County Health Department clinics ; is involved in the prepara-
tion of treatment rooms for use by patients; cleans rooms and
equipment after clinics; and performs routine filing.

•Foreman and Maintenance Man — responsible for the super-
vision and semi-skilled and skilled work in several trades which
are necessary for the maintenance and repair of buildings and
equipment.

•Laborer — a minimum education of six grades is required
and employees must be able to read and write; includes such
workers as domestics and janitorial workers, custodial and security
guards.

424 • FLORIDA HEALTH NOTES

Sckolmkfi . . .

The high school student who is interested in a health career
may find various kinds of scholarships available through the State
Department of Education or through the student financial aid
office of the university or college of his choice. These scholarships
are available in limited numbers and are usually awarded on the
basis of academic excellence, good character, leadership and finan-
cial need. There are also loans or scholarships available through
various federal and state programs and from professional organiza-
tions, such as medical, nursing and engineering societies, and fra-
ternal and civic groups.

Many civic and professional organizations both on a state and
national level, award scholarships for undergraduate and graduate
work in nursing education. The Florida Nursing Association spon-
sors a scholarship program — with money appropriated by each
session of the Florida Legislature — which helps both licensed prac-
tical nurses and two, three and four year nursing students.

High school seniors take competitive examinations each October
for these scholarships which are awarded the following year. A
Nurses Training Act, sponsored by the Federal Government, also
provides scholarships for senior undergraduate and graduate nurs-
ing students who show outstanding leadership ability. N

The State Board of Health offers graduate scholarships for
outstanding staff members which may lead to a master's degree in
public health, sanitary engineering, bacteriology or other special
areas. These are mostly for one year, but occasionally a scholarship
may be for a two or three year period. Exceptions have been made
in the past for scholarships to certain long-time employees which
have permitted them to complete undergraduate degrees.

The State Board of Health also administers one osteopathic and
five dental scholarships each year. For each $2000 dental students
receive, they must work one year in an area of need designated by
the State Board of Health or in a public health clinic. At the present
time, 21 dentists have completed their obligated service by serving
the people in rural areas of Florida. The osteopathic scholarship is

FLORIDA HEALTH NOTES • 425

for $1000 a year and the student carries out one year of obligated
duty for each $1000 received.

There are usually a limited number of summer positions open at
the State Board of Health for college students who are interested
in health careers. The agency also has a work-study cooperative
program with one university whereby students can work on a part-
time basis during the summer months.

Tdkc jiukk Qfpotfmjdm in, Jtmda, , . .

In the opinion of many public health authorities across the
United States, Florida has an outstanding health department sys-
tem — both on the state and county levels. In 1966 the Wall Street
Journal noted that the Florida State Board of Health was one of the
best five of its kind in the United States. This standing was not
achieved by happenstance but through the efforts of thousands of
Florida public health workers during the past 78 years.

Continuous expansion of the state's population and economy
assures Floridians that the health programs will give further op-
portunity for advancement. And, whereas, the state's salaries are
traditionally lower than those in private industry, there have been
improvements in recent times in many classifications which make
them more nearly comparable with private employment.

The other advantages of state employment in public health
include: a Merit System which gives job protection, a retirement
system, life insurance and hospitalization plans and a credit union.
A number of classifications, such as sanitarian, secretary and in-
formation specialist require some form of competitive Merit System
examination; other classifications, such as maids, home health
aides and laborers, do not.

There are some 3800 workers in the State Board of Health and
the 67 County Health Departments who take pleasure in knowing
that they are helping their fellowman through careers in public
health. When you choose a career you are making an important
decision. You will find choosing a health career a most rewarding
experience.

426 • FLORIDA HEALTH NOTES